The metabolic syndrome is a cluster of metabolic abnormalities with abdominal obesity at its centre.

Although all forms of obesity have a negative impact on human health, metabolic syndrome describes a set of particularly adverse biochemical changes accompanying abdominal obesity.

These biochemical changes explain the increase in diabetes and cardiovascular disease ( heart attack, stroke, heart failure ) seen with metabolic syndrome, less clearly seen in those forms of obesity which minimally interfere with metabolism.

Recent guidelines therefore identified the metabolic syndrome as a risk factor for cardiovascular disease deserving increased clinical attention.

Metabolic syndrome is most often identified by having three or more out of five possible abnormalities which form the metabolic syndrome cluster.
These five abnormalities in the cluster are:

1) increased waist circumference ( abdominal obesity ),

2) elevated triglycerides,

3) low HDL-cholesterol,

4) a slightly increased blood glucose level (impaired fasting glycemia ),

5) high blood pressure.

At present few data are available with regard to metabolic syndrome prevalence in Europe and its early links with early cardiac and vascular damage.

Research from the Asklepios Study indicates that in middle-aged subjects ( 35-55 year old ) metabolic syndrome is frequently present ( 9-16% of subjects depending on the definition used ) and that its presence coincides with a wide range of adverse cardiovascular changes.

More specifically we found a strong association between presence of metabolic syndrome and inflammation ( a well documented marker of risk for future heart attacks and stroke ), thickening and stiffening of the heart ( potentially predisposing to heart failure ) and more pronounced atherosclerosis ( calcification and narrowing of the arteries ).
These effects were graded, every additional metabolic syndrome component present translated into a gradually higher likelihood of finding cardiovascular damage.

Whilst subjects with one or two metabolic abnormalities do not have a metabolic syndrome ( three or more components are necessary by definition ), they do have a higher risk than an individual without any metabolic abnormalities.

Metabolic syndrome is not only an all/none diagnosis ( present in 9-16% of the population ) as every additional component of the metabolic syndrome yielded an increase in cardiovascular abnormalities.

The implications of the present findings should therefore also be relevant for much larger segment of the population ( more than 50% ) having at least one metabolic syndrome component.

Furthermore our data suggest that although men in this age group have the metabolic syndrome more frequently, that women seem more prone to its adverse consequences.
Efforts should be focused on awareness of abdominal obesity as a risk factor for developing heart disease, and on wide ranging preventive strategies to avert its consequences.

The Asklepios Study is a cross-sectional and longitudinal population study focusing on the interplay between aging, cardiovascular haemodynamics and inflammation in cardiovascular disease.
The 2524 participants ( 1301 female ) are a representative cohort of apparently healthy 35-55 year-old subjects ( median age 46 years ) randomly sampled from the twinned Belgian communities of Erpe-Mere and Nieuwerkerken.

Source: European Society of Cardiology, 2005


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