Do you have metabolic syndrome?

This hidden condition increases your risk of heart disease, stroke and diabetes - and you may not know you have it... By Dr Sarah Jarvis

At the beginning of my surgery, I always browse through the list of patients who are booked in to see me. In most cases their health problems are fairly minor. But it's a shocking fact that a quarter of my adult patients could have an unpleasant and potentially life-threatening condition - one they're unlikely to know anything about because early symptoms often go unnoticed.

The same is true for one in four of you reading this. Although you probably feel perfectly fit and healthy, you may already be at risk from something known as metabolic syndrome. Experts reckon that in the UK, many people can have this condition for up to 10 years before being diagnosed.

‘Metabolic syndrome trebles your risk of heart disease and stroke - without you even realising it,' says consultant cardiologist Dr Lena Izzat. ‘We now know that identifying metabolic syndrome early and improving your lifestyle is vital.'

What is metabolic syndrome?
Metabolic syndrome (or Syndrome X, as it's also known), is a cluster of risk factors for heart disease and stroke, and an early warning of being at risk of developing diabetes. We don't know exactly what brings it on, but we do know that it is closely connected with a condition called insulin resistance.

Insulin is a hormone produced by our bodies. It lets us take sugar from our bloodstream into our cells, where it is either converted into instant energy, or stored for later use. If you develop insulin resistance, your cells become less responsive and eventually resistant to insulin, so the sugar can't be used by your cells. Your blood sugar levels remain high, and more and more insulin is produced to deal with it.

Having slightly high blood sugar, and high insulin, can damage your muscles and your blood vessels. What's more, the same factors that cause insulin resistance also raise your blood pressure - another risk factor for heart disease. They increase your body's levels of harmful LDL-cholesterol and other blood fats, too.

With metabolic syndrome, people are often lulled into a false sense of security because their total cholesterol levels appear to be normal. However, the problem is that LDL-cholesterol, the kind that gets deposited in the arteries and clogs them up, is high, while the good HDL-cholesterol, which helps to protect the arteries, is low.

Your diabetes risk
As well as dramatically increasing your risk of heart attack or stroke, metabolic syndrome has other implications for your health. Doctors now realise that it is also an important early warning that you're at high risk of developing diabetes. There are two main types of diabetes - type 1 and type 2 - but type 2 is by far the most common. In the past, it was assumed that type 2 diabetes was ‘milder' than type 1 and that keeping your blood sugar under control was enough to cut your risk of complications. In fact, there's much more to it than that.

Having type 2 diabetes can cut an average of 10 years off your lifespan. A staggering four out of five people with type 2 diabetes die of cardiovascular disease - mostly heart attack, stroke and heart failure. And most people have diabetes for an average of five to eight years before they're actually diagnosed. During that time, the damage to your heart (as well as to your kidneys, eyes and nerves) continues unchecked.

The rise in cases of diabetes is so dramatic that the World Health Organisation has called it ‘a global epidemic'. In the UK alone, 1.8 million people have already been diagnosed and another 1 million probably suffer from the disease without knowing about it yet. The most likely cause is a decrease in physical activity combined with an increase in obesity levels - the number of people in Britain who are obese has risen from 14% in 1994 to 22% today.

Assess your risk
The early symptoms of metabolic syndrome are mild or non-specific and anyone can be at risk, but your risk is higher if:
Your BMI is high: You are overweight with a body mass index (BMI) of more than 30.
You store fat around your middle: Doctors now think fat cells that develop around your waist pump out chemicals that can damage your insulin system and increase your cholesterol. You need to worry if you're a woman whose waist measures more than 35 inches (for men, if it's more than 40 inches)
You exercise little or not at all
You have high blood pressure (at least 130/85mm Hg)
You're over 40
You have a family history of type 2 diabetes or had gestational diabetes when you were pregnant
You are from a South Asian or Afro-Caribbean background
Your blood glucose is high: Checks show raised glucose levels (more than 6.1mmol)
You have raised triglycerides in your blood (at least 1.7mmol/l)
You have low HDL (‘good') cholesterol (below 1.3mmol/l for women and below 1.04mmol/l for men)

What can I do?

There are measures you can take to protect yourself from developing metabolic syndrome - click here to find out more 

 

The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP. For more information, visit www.netdoctor.co.uk

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