Understanding Metabolic Syndrome

Metabolic syndrome is a group of conditions that can increase your chances of developing heart disease, stroke and type 2 diabetes.

Do you have metabolic syndrome?

A person is diagnosed with metabolic syndrome if they have at least three of these five key conditions:

Excessive fat in and around the stomach area
Abnormally high blood pressure
Abnormally high levels of triglycerides
Abnormally low levels of high-density lipoproteins (HDL).
Abnormally high levels of blood glucose, commonly known as impaired fasting glucose.

In Australia, it is estimated that about 35% of all adults suffer from metabolic syndrome.

Driving factors of metabolic syndrome

There are multiple underlying risk factors driving the prevalence of metabolic syndrome (MS) and associated conditions. These factors include diet, genetics, drugs and certain chronic diseases, as well as lifestyle choices. Some of the most important risk factors that increase your chances of developing MS include:

Genetic background

If you have a certain ethnic background, you may be at a higher risk of developing metabolic syndrome. For example, a recent study that analysed the health of more than 51,000 Americans from different ethnic background found clear differences in their risk of developing MS¹. The study found that non-Hispanic black men had the highest increase in the prevalence of MS (55%), followed by non-Hispanic white women (44%), and non-Hispanic black women (41%).

Fat around your waist

Being above your optimal weight, and, particularly, having too much fat around your abdomen area is a strong predictor of MS as well as other diseases, like type 2 diabetes and heart disease. In Australia, about 67% of all adults and 25% of all children are overweight or obese.

Diabetes

If you suffered from diabetes during pregnancy, known as gestational diabetes, or if you have a family history of type 2 diabetes, you have a higher risk of developing metabolic syndrome^2-3.

Age and sex

As you get older your risk of developing MS increases. This risk is strongly dependent on what sort of lifestyle you led over the first decades of your life and may also be different if you are male or female^4-5. For example, one study found a higher prevalence of MS among men⁵. The study also found differences between sexes in different risk factors associated with MS. For example, among people below the age of 60 who developed MS, men were more likely to suffer from high blood pressure, whereas women were more likely to have unhealthy abdominal obesity.

Conditions associated with Metabolic Syndrome

If you suffer from certain diseases, like non-alcoholic fatty liver disease (NAFLD), polycystic ovary syndrome (PCOS) or obstructive sleep apnea, you may have an increased risk of developing metabolic syndrome.

NAFLD occurs when the liver contains an excess of fat, which is not due to alcohol consumption. A fatty liver will produce an excess of glucose and triglycerides, two key components of MS. A higher prevalence of NAFLD is associated with obesity, excessive intake of simple sugars and physical inactivity⁶.
Obstructive sleep apnea (OSA) is a condition where there is partial or complete obstruction of the upper airway during sleep. As a consequence, a person experiences recurrent arousal from sleep, difficulties falling asleep and loud snoring, among other problems. The link between OSA and MS is known as “Syndrome Z”, and studies suggest that MS may function as a trigger for the development of OSA. People suffering from OSA, for example, have been shown to have elevated levels of insulin resistance, lower insulin sensitivity, and higher fasting insulin levels. People with OSA may also suffer from an increase in epinephrine, norepinephrine and/or cortisol, which can lead to an increase in gluconeogenesis (formation of glucose) and a decrease in the use of glucose my muscles⁷.
PCOS is a condition characterised by menstrual irregularities, reduced fertility, hyperandrogenism, and hirsutism. Hyperandrogenism is characterised by high levels of androgens and can lead to acne and hair loss, whereas hirsutism is a condition where women grow coarse hair in a male-like pattern, in the face, chest and back. Studies have shown that women with PCOS also suffer many of the typical conditions associated with metabolic syndrome, including visceral obesity, hyperinsulinemia (excessive insulin in the blood) and insulin resistance⁸.

Health consequences of Metabolic Syndrome

People suffering from metabolic disorder are at a higher risk of developing serious conditions, like type 2 diabetes, lipid disorders, cardiovascular disease, hepatic steatosis, circulatory disorders, cancer, stroke, and neurological disorders. Some examples of these conditions include:

Neurological Disorders

Many of the risk factors associated with MS can also alter the optimal functioning of the brain, influencing conditions like Alzheimer’s disease, dementia and cognitive impairment. One mechanism proposed for the link between MS and neurological conditions is through the hypothalamic-pituitary-adrenal (HPA) axis. A person with metabolic syndrome may experience a dysregulation of the HPS axis, which can lead to altered levels of the hormone corticosterone, which is linked a reduced function of glucocorticoid receptors in the hippocampus, an important region for memory formation^9-11.

Type 2 diabetes

People who develop metabolic syndrome are at higher risk of developing diabetes type 2, studies say^12-13. One key mechanism proposed to explain this link involves pancreatic Beta-cell dysfunction. Pancreatic beta cells are responsible for producing, storing, and releasing insulin in the body, a key process necessary for the maintenance of glucose homeostasis – the process responsible for keeping healthy levels of glucose in the blood¹⁴.

Heart disease

If you have been diagnosed with metabolic syndrome, your heart should be a major concern. Studies show that metabolic syndrome is associated with higher mortality from heart disease. In one study, for example, adults between 30 and 74 years of age were found twice as like to die from coronary heart disease if they had metabolic syndrome¹⁵.

Metabolic syndrome focussing on the Gut Microbiome

Our large intestine is home to large communities of bacteria and other microbes, which form the so-called gut microbiota. In recent decades, a vast number of studies have linked the composition of the gut microbiota with risk factors associated with metabolic syndrome.

For example, people suffering from obesity of metabolic dysregulation have a different composition of gut microbes as well as reduced gut microbial diversity. One study found that obese people suffering from type 2 diabetes were more likely to have gut dysbiosis as well as pathogenic bacterial species in their gut, compared to healthy people^16-17.

People at risk of developing metabolic syndrome should consider getting their gut microbiota tested to identify any evidence of gut dysbiosis or the presence of pathogenic bacterial species.

Metabolic syndrome in Australia

In developed countries, like Australia, food is abundant but physical activity is, unfortunately, limited. This is reflected in the most recent health statistics:

In 2017-2018, the Australian Bureau of Statistics’ (ABS) National Health Survey showed that 12.5 million Australians are overweight or obese – that is more than a third (67%) of all adults in Australia. Children are also affected, with the survey showing that about 25% of all Australian children were also overweight or obese during 2017-2018.
During 2017-2018 one in ten Australians (10.6% or 2.6 million people) reported having hypertension, according to the ABS National Health Survey.
According to the Australian Health Survey, in 2011-2012 8.2% of all Australians who were 18 years and over had elevated blood glucose levels.

Unfortunately, there are no recent statistics on the prevalence of metabolic syndrome. The most recent report on metabolic syndrome in Australia dates to 2007, and suggested prevalence levels as high as 30%¹⁸. However, the recent statistics presented above for some of the key risk factors associated with metabolic syndrome, suggest that this condition is still a prevalent problem today.

A Modern Functional Medicine Approach

At the Australian Centre for Functional Medicine, we take an innovative and comprehensive approach to metabolic syndrome, applying for traditional and modern functional medicine. The central tenet of our functional medicine approach towards metabolic syndrome is that, for most patients, metabolic syndrome is a highly treatable and preventable condition.

Making changes in your diet and lifestyle, reducing your exposure to environmental toxins and understanding your unique genetic susceptibilities can have a significant impact on your health. At the Australian Centre for Functional Medicine, we specialise in treating patients who have been diagnosed with metabolic syndrome or who may be at risk of developing this condition. We also treat diseases linked to metabolic syndrome, including heart disease, metabolic dysfunction, and type 2 diabetes.

Our modern functional medicine approach involves an initial evaluation of your current health, including gathering information about your diet and other lifestyle choices and performing comprehensive testing of health biomarkers. Based on this information, we can establish which aspects of your health need to be addressed. The outcome of your visit will involve a customised health plan, which may include traditional medicines as well as botanicals, and changes to your diet and daily routines.

BECOME A PATIENT TODAY and discover the difference in understanding your problems and finding the optimal pathway to health

BECOME A PATIENT

References

Moore JX, Chaudhary N, Akinyemiju T. Peer reviewed: Metabolic syndrome prevalence by race/ethnicity and sex in the United States, National Health and Nutrition Examination Survey, 1988–2012. Preventing chronic disease. 2017;14. Read it!
Puhkala J, Raitanen J, Kolu P, Tuominen P, Husu P, Luoto R. Metabolic syndrome in Finnish women 7 years after a gestational diabetes prevention trial. BMJ open. 2017 Mar 1;7(3). Read it!
Irving R. The Metabolic Syndrome in Adolescents Age 11-18 Years with Familial History of Early Onset Type 2 Diabetes (T2DM). Journal of Advances in Medicine and Medical Research. 2016 Nov 5:1-8. Read it!
Kuk JL, Ardern CI. Age and sex differences in the clustering of metabolic syndrome factors: association with mortality risk. Diabetes care. 2010 Nov 1;33(11):2457-61. Read it!
Slagter SN, van Waateringe RP, van Beek AP, van der Klauw MM, Wolffenbuttel BH, van Vliet-Ostaptchouk JV. Sex, BMI and age differences in metabolic syndrome: the Dutch Lifelines Cohort Study. Endocrine connections. 2017 May 1;6(4):278-88. Read it!
Yki-Järvinen H. Non-alcoholic fatty liver disease as a cause and a consequence of metabolic syndrome. The lancet Diabetes & endocrinology. 2014 Nov 1;2(11):901-10. Read it!
Castaneda A, Jauregui-Maldonado E, Ratnani I, Varon J, Surani S. Correlation between metabolic syndrome and sleep apnea. World Journal of Diabetes. 2018 Apr 15;9(4):66. Read it!
Ali AT. Polycystic ovary syndrome and metabolic syndrome. Ceska gynekologie. 2015 Aug 1;80(4):279-89. Read it!
Farooqui AA, Farooqui T, Panza F, Frisardi V. Metabolic syndrome as a risk factor for neurological disorders. Cellular and Molecular Life Sciences. 2012 Mar 1;69(5):741-62. Read it!
Ríos JA, Cisternas P, Arrese M, Barja S, Inestrosa NC. Is Alzheimer’s disease related to metabolic syndrome? A Wnt signaling conundrum. Progress in neurobiology. 2014 Oct 1;121:125-46. Read it!
Atti AR, Valente S, Iodice A, Caramella I, Ferrari B, Albert U, Mandelli L, De Ronchi D. Metabolic syndrome, mild cognitive impairment, and dementia: A meta-analysis of longitudinal studies. The American Journal of Geriatric Psychiatry. 2019 Jun 1;27(6):625-37. Read it!
Wilson PW, D’Agostino RB, Parise H, Sullivan L, Meigs JB. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation. 2005 Nov 15;112(20):3066-72. Read it!
Hudish LI, Reusch JE, Sussel L. β cell dysfunction during progression of metabolic syndrome to type 2 diabetes. The Journal of clinical investigation. 2019 Aug 19;129(9). Read it!
Hudish LI, Reusch JE, Sussel L. β cell dysfunction during progression of metabolic syndrome to type 2 diabetes. The Journal of clinical investigation. 2019 Aug 19;129(9). Read it!
Malik S, Wong ND, Franklin SS, Kamath TV, L’Italien GJ, Pio JR, Williams GR. Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults. Circulation. 2004 Sep 7;110(10):1245-50. Read it!
Qin J, Li Y, Cai Z, Li S, Zhu J, Zhang F, Liang S, Zhang W, Guan Y, Shen D, Peng Y. A metagenome-wide association study of gut microbiota in type 2 diabetes. Nature. 2012 Oct;490(7418):55-60. Read it!
De Clercq NC, Frissen MN, Groen AK, Nieuwdorp M. Gut microbiota and the gut-brain axis: new insights in the pathophysiology of metabolic syndrome. Psychosomatic Medicine. 2017 Oct 1;79(8):874-9. Read it!
Cameron AJ, Magliano DJ, Zimmet PZ, Welborn T, Shaw JE. The metabolic syndrome in Australia: prevalence using four definitions. Diabetes research and clinical practice. 2007 Sep 1;77(3):471-8. Read it!