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Sections Metabolic Syndrome
- Overview
- Presentation
- DDx
- Workup
- Treatment
- Medication
- Medication Summary
- Antidiabetics, Biguanides
- Antidiabetics, Thiazolidinediones
- Lipid-Lowering Agents, Statins
- ACE Inhibitors
- Angiotensin II Receptor Blockers (ARBs)
- Lipid-lowering Agents, Non-Statin
- Lipid-Lowering Agents, Non-Statin
- Antiplatelet Agents, Cardiovascular
- Antidiabetics, SGLT2 Inhibitors
- Antidiabetics, Glucagon-like Peptide-1 Agonists
- Show All
- Questions & Answers
- References
History
As with other diseases, careful history taking is important in metabolic syndrome. Even though the condition is diagnosed based on physical and laboratory features, it may be suspected if symptoms of any of the component disorders are present, such as the increased hunger, thirst, or urination that may accompany hyperglycemia.
Patients reporting a history of hypertension, dyslipidemia, or hyperglycemia warrant screening for metabolic syndrome. Symptoms suggesting the rise of cardiovascular and other complications, such as chest pain or shortness of breath, must be investigated carefully. As lifestyle changes can ameliorate the condition, attention should be paid to the patient’s dietary habits and exercise routines so that areas for improvement can be identified.
The patient’s social history is important for identifying additional risks, such as tobacco use, which may exacerbate the increased cardiovascular complications associated with metabolic syndrome.
A family history should be obtained because genetics may play an important role in metabolic syndrome. This feature of the disease is under active investigation; however, no gene or group of genes has yet been implicated consistently, suggesting that environment exerts substantial influence. [80]
Finally, a thorough review of systems may help to identify related problems, such as menstrual irregularities that can be seen in polycystic ovarian syndrome.
Physical Examination
The physical examination is crucial in patients with metabolic syndrome, as the findings of elevated blood pressure and abdominal obesity are 2 of the 5 diagnostic criteria. Measurement and documentation of waist circumference are important routines when screening for metabolic syndrome.
The examination may also reveal findings reflective of the other criteria. For example, patients with insulin resistance and hyperglycemia or with diabetes mellitus may have acanthosis nigricans, hirsutism, peripheral neuropathy, and retinopathy. Patients with severe dyslipidemia may have xanthomas or xanthelasmas. The presence of arterial bruits may portend a higher risk of cardiovascular complications.
Olufadi R, Byrne CD. Clinical and laboratory diagnosis of the metabolic syndrome. J Clin Pathol. 2008 Jun. 61(6):697-706. [QxMD MEDLINE Link].
Hernandez-Baixauli J, Quesada-Vazquez S, Marine-Casado R, et al. Detection of early disease risk factors associated with metabolic syndrome: a new era with the NMR metabolomics assessment. Nutrients. 2020 Mar 18. 12 (3):[QxMD MEDLINE Link]. [Full Text].
[Guideline] Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009 Oct 20. 120(16):1640-5. [QxMD MEDLINE Link].
Tasali E, Ip MS. Obstructive sleep apnea and metabolic syndrome: alterations in glucose metabolism and inflammation. Proc Am Thorac Soc. 2008 Feb 15. 5(2):207-17. [QxMD MEDLINE Link].
Yoneda M, Yamane K, Jitsuiki K, et al. Prevalence of metabolic syndrome compared between native Japanese and Japanese-Americans. Diabetes Res Clin Pract. 2008 Mar. 79(3):518-22. [QxMD MEDLINE Link].
Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005 Oct 25. 112(17):2735-52. [QxMD MEDLINE Link].
Hanley AJ, Karter AJ, Williams K, et al. Prediction of type 2 diabetes mellitus with alternative definitions of the metabolic syndrome: the Insulin Resistance Atherosclerosis Study. Circulation. 2005 Dec 13. 112(24):3713-21. [QxMD MEDLINE Link].
Gami AS, Witt BJ, Howard DE, et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007 Jan 30. 49(4):403-14. [QxMD MEDLINE Link].
Giovannucci E. Metabolic syndrome, hyperinsulinemia, and colon cancer: a review. Am J Clin Nutr. 2007 Sep. 86(3):s836-42. [QxMD MEDLINE Link].
Xu H, Li X, Adams H, Kubena K, Guo S. Etiology of metabolic syndrome and dietary intervention. Int J Mol Sci. 2018 Dec 31. 20 (1):[QxMD MEDLINE Link]. [Full Text].
Sattar N, McConnachie A, Shaper AG, et al. Can metabolic syndrome usefully predict cardiovascular disease and diabetes? Outcome data from two prospective studies. Lancet. 2008 Jun 7. 371(9628):1927-35. [QxMD MEDLINE Link].
Nilsson PM. Cardiovascular risk in the metabolic syndrome: fact or fiction?. Curr Cardiol Rep. 2007 Nov. 9(6):479-85. [QxMD MEDLINE Link].
Grundy SM. Metabolic syndrome: a multiplex cardiovascular risk factor. J Clin Endocrinol Metab. 2007 Feb. 92(2):399-404. [QxMD MEDLINE Link].
Cuspidi C, Sala C, Zanchetti A. Metabolic syndrome and target organ damage: role of blood pressure. Expert Rev Cardiovasc Ther. 2008 Jun. 6(5):731-43. [QxMD MEDLINE Link].
Serne EH, de Jongh RT, Eringa EC, et al. Microvascular dysfunction: a potential pathophysiological role in the metabolic syndrome. Hypertension. 2007 Jul. 50(1):204-11. [QxMD MEDLINE Link].
Alessi MC, Juhan-Vague I. Metabolic syndrome, haemostasis and thrombosis. Thromb Haemost. 2008 Jun. 99(6):995-1000. [QxMD MEDLINE Link].
Stehouwer CD, Henry RM, Ferreira I. Arterial stiffness in diabetes and the metabolic syndrome: a pathway to cardiovascular disease. Diabetologia. 2008 Apr. 51(4):527-39. [QxMD MEDLINE Link].
Elnakish MT, Hassanain HH, Janssen PM, Angelos MG, Khan M. Emerging role of oxidative stress in metabolic syndrome and cardiovascular diseases: important role of Rac/NADPH oxidase. J Pathol. 2013 Nov. 231(3):290-300. [QxMD MEDLINE Link].
Yubero-Serrano EM, Delgado-Lista J, Pena-Orihuela P, et al. Oxidative stress is associated with the number of components of metabolic syndrome: LIPGENE study. Exp Mol Med. 2013 Jun 21. 45:e28. [QxMD MEDLINE Link]. [Full Text].
Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of obesity among adults and youth: United States, 2011-2014. NCHS Data Brief. 2015 Nov. 1-8. [QxMD MEDLINE Link].
Saklayen MG. The global epidemic of the metabolic syndrome. Curr Hypertens Rep. 2018 Feb 26. 20 (2):12. [QxMD MEDLINE Link].
Goossens GH. The role of adipose tissue dysfunction in the pathogenesis of obesity-related insulin resistance. Physiol Behav. 2008 May 23. 94(2):206-18. [QxMD MEDLINE Link].
Gustafson B, Hammarstedt A, Andersson CX, et al. Inflamed adipose tissue: a culprit underlying the metabolic syndrome and atherosclerosis. Arterioscler Thromb Vasc Biol. 2007 Nov. 27(11):2276-83. [QxMD MEDLINE Link].
Lann D, LeRoith D. Insulin resistance as the underlying cause for the metabolic syndrome. Med Clin North Am. 2007 Nov. 91(6):1063-77, viii. [QxMD MEDLINE Link].
Despres JP, Lemieux I, Bergeron J, et al. Abdominal obesity and the metabolic syndrome: contribution to global cardiometabolic risk. Arterioscler Thromb Vasc Biol. 2008 Jun. 28(6):1039-49. [QxMD MEDLINE Link].
Turkoglu C, Duman BS, Gunay D, Cagatay P, Ozcan R, Buyukdevrim AS. Effect of abdominal obesity on insulin resistance and the components of the metabolic syndrome: evidence supporting obesity as the central feature. Obes Surg. 2003 Oct. 13(5):699-705. [QxMD MEDLINE Link].
Goldbacher EM, Matthews KA. Are psychological characteristics related to risk of the metabolic syndrome? A review of the literature. Ann Behav Med. 2007 Nov-Dec. 34(3):240-52. [QxMD MEDLINE Link].
Sardinha A, Nardi AE. The Role of Anxiety in Metabolic Syndrome. Medscape. Available at http://www.medscape.com/viewarticle/755474_4. Accessed: December 4, 2013.
Grundy SM. Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol. 2008 Apr. 28(4):629-36. [QxMD MEDLINE Link].
Ford ES, Giles WH, Mokdad AH. Increasing prevalence of the metabolic syndrome among U.S. adults. Diabetes Care. 2004 Oct. 27(10):2444-9. [QxMD MEDLINE Link].
Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics-2016 update: a report from the American Heart Association. Circulation. 2015 Dec 16. 133:[QxMD MEDLINE Link]. [Full Text].
Lovre D, Mauvais-Jarvis F. Trends in prevalence of the metabolic syndrome. JAMA. 2015 Sep 1. 314(9):950. [QxMD MEDLINE Link].
Hoang KC, Le TV, Wong ND. The metabolic syndrome in East Asians. J Cardiometab Syndr. 2007 Fall. 2(4):276-82. [QxMD MEDLINE Link].
Hwang LC, Bai CH, Chen CJ. Prevalence of obesity and metabolic syndrome in Taiwan. J Formos Med Assoc. 2006 Aug. 105(8):626-35. [QxMD MEDLINE Link].
Nestel P, Lyu R, Low LP, et al. Metabolic syndrome: recent prevalence in East and Southeast Asian populations. Asia Pac J Clin Nutr. 2007. 16(2):362-7. [QxMD MEDLINE Link].
Kohro T, Furui Y, Mitsutake N, et al. The Japanese national health screening and intervention program aimed at preventing worsening of the metabolic syndrome. Int Heart J. 2008 Mar. 49(2):193-203. [QxMD MEDLINE Link].
Kolovou GD, Anagnostopoulou KK, Salpea KD, et al. The prevalence of metabolic syndrome in various populations. Am J Med Sci. 2007 Jun. 333(6):362-71. [QxMD MEDLINE Link].
Hu G, Lindstrom J, Jousilahti P, et al. The increasing prevalence of metabolic syndrome among Finnish men and women over a decade. J Clin Endocrinol Metab. 2008 Mar. 93(3):832-6. [QxMD MEDLINE Link].
Erem C, Hacihasanoglu A, Deger O, et al. Prevalence of metabolic syndrome and associated risk factors among Turkish adults: Trabzon MetS study. Endocrine. 2008 Feb. 33(1):9-20. [QxMD MEDLINE Link].
Mahadik SR, Deo SS, Mehtalia SD. Increased prevalence of metabolic syndrome in non-obese Asian Indian-an urban-rural comparison. Metab Syndr Relat Disord. 2007 Jun. 5(2):142-52. [QxMD MEDLINE Link].
Mokan M, Galajda P, Pridavkova D, et al. Prevalence of diabetes mellitus and metabolic syndrome in Slovakia. Diabetes Res Clin Pract. 2008 Aug. 81(2):238-42. [QxMD MEDLINE Link].
Malik M, Razig SA. The prevalence of the metabolic syndrome among the multiethnic population of the United Arab Emirates: a report of a national survey. Metab Syndr Relat Disord. 2008 Fall. 6(3):177-86. [QxMD MEDLINE Link].
Banerjee D, Misra A. Does using ethnic specific criteria improve the usefulness of the term metabolic syndrome? Controversies and suggestions. Int J Obes (Lond). 2007 Sep. 31(9):1340-9. [QxMD MEDLINE Link].
Clark LT, El-Atat F. Metabolic syndrome in African Americans: implications for preventing coronary heart disease. Clin Cardiol. 2007 Apr. 30(4):161-4. [QxMD MEDLINE Link].
Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA. 2002 Jan 16. 287(3):356-9. [QxMD MEDLINE Link].
Ukegbu UJ, Castillo DC, Knight MG, et al. Metabolic syndrome does not detect metabolic risk in African men living in the U.S. Diabetes Care. 2011 Oct. 34(10):2297-9. [QxMD MEDLINE Link]. [Full Text].
Bentley-Lewis R, Koruda K, Seely EW. The metabolic syndrome in women. Nat Clin Pract Endocrinol Metab. 2007 Oct. 3(10):696-704. [QxMD MEDLINE Link].
Essah PA, Wickham EP, Nestler JE. The metabolic syndrome in polycystic ovary syndrome. Clin Obstet Gynecol. 2007 Mar. 50(1):205-25. [QxMD MEDLINE Link].
Cussons AJ, Stuckey BG, Watts GF. Metabolic syndrome and cardiometabolic risk in PCOS. Curr Diab Rep. 2007 Feb. 7(1):66-73. [QxMD MEDLINE Link].
Xue F, Michels KB. Diabetes, metabolic syndrome, and breast cancer: a review of the current evidence. Am J Clin Nutr. 2007 Sep. 86(3):s823-35. [QxMD MEDLINE Link].
Ramos RG, Olden K. The prevalence of metabolic syndrome among US women of childbearing age. Am J Public Health. 2008 Jun. 98(6):1122-7. [QxMD MEDLINE Link].
Bhasin S, Jasjua GK, Pencina M, et al. Sex hormone-binding globulin, but not testosterone, is associated prospectively and independently with incident metabolic syndrome in men: the framingham heart study. Diabetes Care. 2011 Nov. 34(11):2464-70. [QxMD MEDLINE Link]. [Full Text].
Tsujimura A, Miyagawa Y, Takezawa K, et al. Is low testosterone concentration a risk factor for metabolic syndrome in healthy middle-aged men?. Urology. 2013 Oct. 82(4):814-9. [QxMD MEDLINE Link].
De Ferranti SD, Osganian SK. Epidemiology of paediatric metabolic syndrome and type 2 diabetes mellitus. Diab Vasc Dis Res. 2007 Dec. 4(4):285-96. [QxMD MEDLINE Link].
Zimmet P, Alberti KG, Kaufman F, et al. The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes. 2007 Oct. 8(5):299-306. [QxMD MEDLINE Link].
Morrison JA, Ford ES, Steinberger J. The pediatric metabolic syndrome. Minerva Med. 2008 Jun. 99(3):269-87. [QxMD MEDLINE Link].
Umetani K, Kodama Y, Nakamura T, et al. High prevalence of paroxysmal atrial fibrillation and/or atrial flutter in metabolic syndrome. Circ J. 2007 Feb. 71(2):252-5. [QxMD MEDLINE Link].
Watanabe H, Tanabe N, Watanabe T, Darbar D, Roden DM, Sasaki S. Metabolic syndrome and risk of development of atrial fibrillation: the Niigata preventive medicine study. Circulation. 2008 Mar 11. 117(10):1255-60. [QxMD MEDLINE Link].
Maron BA, Leopold JA, Hemnes AR. Metabolic syndrome, neurohumoral modulation, and pulmonary arterial hypertension. Br J Pharmacol. 2020 Apr. 177 (7):1457-71. [QxMD MEDLINE Link]. [Full Text].
Briand M, Lemieux I, Dumesnil JG, et al. Metabolic syndrome negatively influences disease progression and prognosis in aortic stenosis. J Am Coll Cardiol. 2006 Jun 6. 47(11):2229-36. [QxMD MEDLINE Link].
Obunai K, Jani S, Dangas GD. Cardiovascular morbidity and mortality of the metabolic syndrome. Med Clin North Am. 2007 Nov. 91(6):1169-84, x. [QxMD MEDLINE Link].
Mraovic B, Hipszer BR, Epstein RH, et al. Metabolic syndrome increases risk for pulmonary embolism after hip and knee arthroplasty. Croat Med J. 2013 Aug. 54(4):355-61. [QxMD MEDLINE Link].
Towfighi A, Ovbiagele B. Metabolic syndrome and stroke. Curr Diab Rep. 2008 Feb. 8(1):37-41. [QxMD MEDLINE Link].
Air EL, Kissela BM. Diabetes, the metabolic syndrome, and ischemic stroke: epidemiology and possible mechanisms. Diabetes Care. 2007 Dec. 30(12):3131-40. [QxMD MEDLINE Link].
Callaghan B, Feldman E. The metabolic syndrome and neuropathy: therapeutic challenges and opportunities. Ann Neurol. 2013 Sep. 74(3):397-403. [QxMD MEDLINE Link]. [Full Text].
Lidofsky SD. Nonalcoholic fatty liver disease: diagnosis and relation to metabolic syndrome and approach to treatment. Curr Diab Rep. 2008 Feb. 8(1):25-30. [QxMD MEDLINE Link].
Kotronen A, Yki-Jarvinen H. Fatty liver: a novel component of the metabolic syndrome. Arterioscler Thromb Vasc Biol. 2008 Jan. 28(1):27-38. [QxMD MEDLINE Link].
Tarantino G, Finelli C. What about non-alcoholic fatty liver disease as a new criterion to define metabolic syndrome?. World J Gastroenterol. 2013 Jun 14. 19(22):3375-84. [QxMD MEDLINE Link]. [Full Text].
Beaulieu LM, Whitley BR, Wiesner TF, et al. Breast cancer and metabolic syndrome linked through the plasminogen activator inhibitor-1 cycle. Bioessays. 2007 Oct. 29(10):1029-38. [QxMD MEDLINE Link].
Hsing AW, Sakoda LC, Chua S Jr. Obesity, metabolic syndrome, and prostate cancer. Am J Clin Nutr. 2007 Sep. 86(3):s843-57. [QxMD MEDLINE Link].
Gottlieb AB, Dann F, Menter A. Psoriasis and the metabolic syndrome. J Drugs Dermatol. 2008 Jun. 7(6):563-72. [QxMD MEDLINE Link].
Cohen AD, Sherf M, Vidavsky L, et al. Association between psoriasis and the metabolic syndrome. A cross-sectional study. Dermatology. 2008. 216(2):152-5. [QxMD MEDLINE Link].
Harding, A. Metabolic syndrome sharply boosts risk of recurrent pre-eclampsia. Medscape News from WebMD. March 21, 2013. Available at http://www.medscape.com/viewarticle/781185. Accessed: March 26, 2013.
Stekkinger E, Scholten R, van der Vlugt MJ, van Dijk AP, Janssen MC, Spaanderman ME. Metabolic syndrome and the risk for recurrent pre-eclampsia: a retrospective cohort study. BJOG. 2013 Jul. 120(8):979-86. [QxMD MEDLINE Link].
Taylor VH, MacQueen GM. Cognitive dysfunction associated with metabolic syndrome. Obes Rev. 2007 Sep. 8(5):409-18. [QxMD MEDLINE Link].
Yaffe K. Metabolic syndrome and cognitive decline. Curr Alzheimer Res. 2007 Apr. 4(2):123-6. [QxMD MEDLINE Link].
Newcomer JW. Metabolic syndrome and mental illness. Am J Manag Care. 2007 Nov. 13(7 Suppl):S170-7. [QxMD MEDLINE Link].
Fiedorowicz JG, Palagummi NM, Forman-Hoffman VL, et al. Elevated prevalence of obesity, metabolic syndrome, and cardiovascular risk factors in bipolar disorder. Ann Clin Psychiatry. 2008 Jul-Sep. 20(3):131-7. [QxMD MEDLINE Link].
Esposito K, Chiodini P, Capuano A, Colao A, Giugliano D. Fracture risk and bone mineral density in metabolic syndrome: a meta-analysis. J Clin Endocrinol Metab. 2013 Aug. 98(8):3306-14. [QxMD MEDLINE Link].
Joy T, Lahiry P, Pollex RL, et al. Genetics of metabolic syndrome. Curr Diab Rep. 2008 Apr. 8(2):141-8. [QxMD MEDLINE Link].
Heima NE, Eekhoff EM, Oosterwerff MM, Lips PT, van Schoor NM, Simsek S. Thyroid function and the metabolic syndrome in older persons: a population-based study. Eur J Endocrinol. 2013 Jan. 168(1):59-65. [QxMD MEDLINE Link].
Puig JG, Martinez MA. Hyperuricemia, gout and the metabolic syndrome. Curr Opin Rheumatol. 2008 Mar. 20(2):187-91. [QxMD MEDLINE Link].
Lam JC, Ip MS. An update on obstructive sleep apnea and the metabolic syndrome. Curr Opin Pulm Med. 2007 Nov. 13(6):484-9. [QxMD MEDLINE Link].
[Guideline] Goff DC Jr, Lloyd-Jones DM, Bennett G, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014 Jun 24. 129(25 Suppl 2):S49-73. [QxMD MEDLINE Link]. [Full Text].
Welty FK, Alfaddagh A, Elajami TK. Targeting inflammation in metabolic syndrome. Transl Res. 2016 Jan. 167(1):257-80. [QxMD MEDLINE Link].
Tupper T, Gopalakrishnan G. Prevention of diabetes development in those with the metabolic syndrome. Med Clin North Am. 2007 Nov. 91(6):1091-105, viii-ix. [QxMD MEDLINE Link].
James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014 Feb 5. 311(5):507-20. [QxMD MEDLINE Link].
Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014 Jul 1. 63(25 Pt B):2960-84. [QxMD MEDLINE Link].
Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014 Jul 1. 63(25 Pt B):2985-3023. [QxMD MEDLINE Link].
Kini S, Herron DM, Yanagisawa RT. Bariatric surgery for morbid obesity--a cure for metabolic syndrome?. Med Clin North Am. 2007 Nov. 91(6):1255-71, xi. [QxMD MEDLINE Link].
Bagry HS, Raghavendran S, Carli F. Metabolic syndrome and insulin resistance: perioperative considerations. Anesthesiology. 2008 Mar. 108(3):506-23. [QxMD MEDLINE Link].
Drager LF, Togeiro SM, Polotsky VY, Lorenzi-Filho G. Obstructive sleep apnea: a cardiometabolic risk in obesity and the metabolic syndrome. J Am Coll Cardiol. 2013 Aug 13. 62(7):569-76. [QxMD MEDLINE Link].
Sharma SK, Agrawal S, Damodaran D, et al. CPAP for the metabolic syndrome in patients with obstructive sleep apnea. N Engl J Med. 2011 Dec 15. 365(24):2277-86. [QxMD MEDLINE Link].
Suzuki T, Homma S. Treatment of hypertension and other cardiovascular risk factors in patients with metabolic syndrome. Med Clin North Am. 2007 Nov. 91(6):1211-23, x. [QxMD MEDLINE Link].
Towne SP, Thara E. Do statins reduce events in patients with metabolic syndrome?. Curr Atheroscler Rep. 2008 Feb. 10(1):39-44. [QxMD MEDLINE Link].
Nissen SE, Tardif JC, Nicholls SJ, et al. Effect of torcetrapib on the progression of coronary atherosclerosis. N Engl J Med. 2007 Mar 29. 356(13):1304-16. [QxMD MEDLINE Link].
Cannon CP, Dansky HM, Davidson M, et al. Design of the DEFINE trial: determining the EFficacy and tolerability of CETP INhibition with AnacEtrapib. Am Heart J. 2009 Oct. 158(4):513-519.e3. [QxMD MEDLINE Link].
Barter PJ, Rye KA. Is there a role for fibrates in the management of dyslipidemia in the metabolic syndrome?. Arterioscler Thromb Vasc Biol. 2008 Jan. 28(1):39-46. [QxMD MEDLINE Link].
Ito MK. The metabolic syndrome: pathophysiology, clinical relevance, and use of niacin. Ann Pharmacother. 2004 Feb. 38(2):277-85. [QxMD MEDLINE Link].
Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014 Jul 1. 63(25 Pt B):2889-934. [QxMD MEDLINE Link].
Chan DC, Watts GF, Barrett PH, et al. Regulatory effects of HMG CoA reductase inhibitor and fish oils on apolipoprotein B-100 kinetics in insulin-resistant obese male subjects with dyslipidemia. Diabetes. 2002 Aug. 51(8):2377-86. [QxMD MEDLINE Link].
Orchard TJ, Temprosa M, Goldberg R, et al. The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Ann Intern Med. 2005 Apr 19. 142(8):611-9. [QxMD MEDLINE Link].
Nieuwdorp M, Stroes ES, Kastelein JJ. Normalization of metabolic syndrome using fenofibrate, metformin or their combination. Diabetes Obes Metab. 2007 Nov. 9(6):869-78. [QxMD MEDLINE Link].
Derosa G, D'Angelo A, Ragonesi PD, et al. Metabolic effects of pioglitazone and rosiglitazone in patients with diabetes and metabolic syndrome treated with metformin. Intern Med J. 2007 Feb. 37(2):79-86. [QxMD MEDLINE Link].
Di Pino A, DeFronzo RA. Insulin resistance and atherosclerosis: implications for insulin-sensitizing agents. Endocr Rev. 2019 Dec 1. 40 (6):1447-67. [QxMD MEDLINE Link].
Bragt MC, Popeijus HE. Peroxisome proliferator-activated receptors and the metabolic syndrome. Physiol Behav. 2008 May 23. 94(2):187-97. [QxMD MEDLINE Link].
[Guideline] Skyler JS, Bergenstal R, Bonow RO, et al. Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA Diabetes Trials: a position statement of the American Diabetes Association and a Scientific Statement of the American College of Cardiology Foundation and the American Heart Association. J Am Coll Cardiol. 2009 Jan 20. 53(3):298-304. [QxMD MEDLINE Link].
Shields TM, Hennekens CH. Management of metabolic syndrome: aspirin. Endocrinol Metab Clin North Am. 2004 Sep. 33(3):577-93, vii. [QxMD MEDLINE Link].
Blaha MJ, Bansal S, Rouf R, et al. A practical "ABCDE" approach to the metabolic syndrome. Mayo Clin Proc. 2008 Aug. 83(8):932-41. [QxMD MEDLINE Link].
Yin J, Zhang H, Ye J. Traditional Chinese medicine in treatment of metabolic syndrome. Endocr Metab Immune Disord Drug Targets. 2008 Jun. 8(2):99-111. [QxMD MEDLINE Link].
Hollander JM, Mechanick JI. Complementary and alternative medicine and the management of the metabolic syndrome. J Am Diet Assoc. 2008 Mar. 108(3):495-509. [QxMD MEDLINE Link].
Ruidavets JB, Bongard V, Dallongeville J, et al. High consumptions of grain, fish, dairy products and combinations of these are associated with a low prevalence of metabolic syndrome. J Epidemiol Community Health. 2007 Sep. 61(9):810-7. [QxMD MEDLINE Link].
Mattei J, Bhupathiraju S, Tucker KL. Higher adherence to a diet score based on American Heart Association recommendations is associated with lower odds of allostatic load and metabolic syndrome in Puerto Rican adults. J Nutr. 2013 Nov. 143(11):1753-9. [QxMD MEDLINE Link]. [Full Text].
Esposito K, Ciotola M, Giugliano D. Mediterranean diet and the metabolic syndrome. Mol Nutr Food Res. 2007 Oct. 51(10):1268-74. [QxMD MEDLINE Link].
Buitrago-Lopez A, Sanderson J, Johnson L, et al. Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis. BMJ. 2011 Aug 26. 343:d4488. [QxMD MEDLINE Link]. [Full Text].
Liu L, Wang Y, Lam KS, et al. Moderate wine consumption in the prevention of metabolic syndrome and its related medical complications. Endocr Metab Immune Disord Drug Targets. 2008 Jun. 8(2):89-98. [QxMD MEDLINE Link].
Cho S, Namkoong K, Shin M, et al. Cardiovascular protective effects and clinical applications of resveratrol. J Med Food. 2017 Mar 27. [QxMD MEDLINE Link].
Miller A, Adeli K. Dietary fructose and the metabolic syndrome. Curr Opin Gastroenterol. 2008 Mar. 24(2):204-9. [QxMD MEDLINE Link].
Johnson RJ, Segal MS, Sautin Y, et al. Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease. Am J Clin Nutr. 2007 Oct. 86(4):899-906. [QxMD MEDLINE Link].
Vrolix R, van Meijl LE, Mensink RP. The metabolic syndrome in relation with the glycemic index and the glycemic load. Physiol Behav. 2008 May 23. 94(2):293-9. [QxMD MEDLINE Link].
Yubero-Serrano EM, Delgado-Lista J, Tierney AC, et al. Insulin resistance determines a differential response to changes in dietary fat modification on metabolic syndrome risk factors: the LIPGENE study. Am J Clin Nutr. 2015 Dec. 102(6):1509-17. [QxMD MEDLINE Link].
Roberts CK, Hevener AL, Barnard RJ. Metabolic syndrome and insulin resistance: underlying causes and modification by exercise training. Compr Physiol. 2013 Jan. 3(1):1-58. [QxMD MEDLINE Link].
Fappa E, Yannakoulia M, Pitsavos C, et al. Lifestyle intervention in the management of metabolic syndrome: could we improve adherence issues?. Nutrition. 2008 Mar. 24(3):286-91. [QxMD MEDLINE Link].
Department of Health and Human Services, Centers for Disease Control and Prevention. Physical activity and health: the benefits of physical activity. Available at http://www.cdc.gov/physicalactivity/basics/pa-health/index.htm. Accessed: December 26, 2015.
Broekhuizen LN, Boekholdt SM, Arsenault BJ, et al. Physical activity, metabolic syndrome, and coronary risk: the EPIC-Norfolk prospective population study. Eur J Cardiovasc Prev Rehabil. 2011 Apr. 18(2):209-17. [QxMD MEDLINE Link].
Shuval K, Finley CE, Chartier KG, Balasubramanian BA, Gabriel KP, Barlow CE. Cardiorespiratory fitness, alcohol intake, and metabolic syndrome incidence in men. Med Sci Sports Exerc. 2012 Nov. 44(11):2125-31. [QxMD MEDLINE Link].
Hamilton MT, Hamilton DG, Zderic TW. Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes. 2007 Nov. 56(11):2655-67. [QxMD MEDLINE Link].
[Guideline] Goldstein LB, Bushnell CD, Adams RJ, et al. Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011 Feb. 42(2):517-84. [QxMD MEDLINE Link].
Hall MH, Muldoon MF, Jennings JR, Buysse DJ, Flory JD, Manuck SB. Self-reported sleep duration is associated with the metabolic syndrome in midlife adults. Sleep. 2008 May. 31(5):635-43. [QxMD MEDLINE Link]. [Full Text].
Kawada T, Otsuka T. Effect of shift work on the development of metabolic syndrome after 3 years in Japanese male workers. Arch Environ Occup Health. 2014. 69(1):55-61. [QxMD MEDLINE Link].
McCall B. Resveratrol boosts bone formation in obese men. Medscape Medical News from WebMD. Available at http://www.medscape.com/viewarticle/833807. October 24, 2014; Accessed: October 25, 2014.
Ornstrup MJ, Harslof T, Kjaer TN, Langdahl BL, Pedersen SB. Resveratrol increases bone mineral density and bone alkaline phosphatase in obese men: a randomized placebo-controlled trial. J Clin Endocrinol Metab. 2014 Dec. 99(12):4720-9. [QxMD MEDLINE Link].
Marso SP, Daniels GH, Brown-Frandsen K, et al, for the LEADER Steering Committee, LEADER Trial Investigators. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016 Jul 28. 375 (4):311-22. [QxMD MEDLINE Link].
Marso SP, Bain SC, Consoli A, et al, for the SUSTAIN-6 Investigators. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016 Nov 10. 375 (19):1834-44. [QxMD MEDLINE Link]. [Full Text].
Bateman LA, Slentz CA, Willis LH, et al. Comparison of aerobic versus resistance exercise training effects on metabolic syndrome (from the Studies of a Targeted Risk Reduction Intervention Through Defined Exercise - STRRIDE-AT/RT). Am J Cardiol. 2011 Sep 15. 108(6):838-44. [QxMD MEDLINE Link].
Brauser D. Binge eating more likely to lead to metabolic syndrome in men. Medscape Medical News from WebMD. Available at http://www.medscape.com/viewarticle/811732. September 26, 2013; Accessed: October 7, 2013.
Udo T, McKee SA, White MA, Masheb RM, Barnes RD, Grilo CM. Sex differences in biopsychosocial correlates of binge eating disorder: a study of treatment-seeking obese adults in primary care setting. Gen Hosp Psychiatry. 2013 Nov-Dec. 35(6):587-91. [QxMD MEDLINE Link].
Alkhatatbeh MJ, Abdul-Razzak KK, Khasawneh LQ, Saadeh NA. High prevalence of vitamin D deficiency and correlation of serum vitamin D with cardiovascular risk in patients with metabolic syndrome. Metab Syndr Relat Disord. 2017 Mar 27. [QxMD MEDLINE Link].
Tucker ME. FDA grants liraglutide cardiovascular events indication. Medscape Medical News. Available at http://medscape.com/viewarticle/884726. August 25, 2017; Accessed: October 1, 2019.
Raatikainen I, Mantyselka P, Vanhala M, et al. Leisure time physical activity and its relation to psychiatric comorbidities in depression. Findings from Finnish Depression and Metabolic Syndrome in Adults (FDMSA) study. J Affect Disord. 2019 Dec 1. 259:150-3. [QxMD MEDLINE Link].
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Stanley S Wang, JD, MD, MPH Clinical Cardiologist, Austin Heart South; Director of Legislative Affairs, Austin Heart; Medical Director, Sleep Disorders Center at Heart Hospital of Austin; Assistant Professor of Medicine (Adjunct), University of North Carolina School of Medicine
Stanley S Wang, JD, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American College of Cardiology, American Heart Association, American Stroke Association, Texas Medical Association
Disclosure: Nothing to disclose.
Yasmine S Ali, MD, MSCI, FACC, FACP Assistant Clinical Professor of Medicine, Vanderbilt University School of Medicine; President, LastSky Writing, LLC
Yasmine S Ali, MD, MSCI, FACC, FACP is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Heart Association, American Medical Association, American Medical Writers Association, National Lipid Association, Tennessee Medical Association
Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: LastSky Writing;Philips Healthcare;M Health;Athena Health;PeerView Institute;Verywell Health; HealthCentral;MedEdicus;Pharmaceutical Training Institute;Elsevier;MedStudy;North American Thrombosis Forum;WellnessVerge;Prose Media; AKH, Inc.<br/>Serve(d) as a speaker or a member of a speakers bureau for: North American Thrombosis Forum.
Justin D Pearlman, MD, ME, PhD, FACC, MA Chief, Division of Cardiology, Director of Cardiology Consultative Service, Director of Cardiology Clinic Service, Director of Cardiology Non-Invasive Laboratory, Director of Cardiology Quality Program KMC, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School
Justin D Pearlman, MD, ME, PhD, FACC, MA is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Federation for Medical Research, International Society for Magnetic Resonance in Medicine, and Radiological Society of North America
Disclosure: Nothing to disclose.
Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Medscape Salary Employment
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Sections Metabolic Syndrome
- Overview
- Presentation
- DDx
- Workup
- Treatment
- Medication
- Medication Summary
- Antidiabetics, Biguanides
- Antidiabetics, Thiazolidinediones
- Lipid-Lowering Agents, Statins
- ACE Inhibitors
- Angiotensin II Receptor Blockers (ARBs)
- Lipid-lowering Agents, Non-Statin
- Lipid-Lowering Agents, Non-Statin
- Antiplatelet Agents, Cardiovascular
- Antidiabetics, SGLT2 Inhibitors
- Antidiabetics, Glucagon-like Peptide-1 Agonists
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- Questions & Answers
- References
