Metabolic Syndrome Clinical Presentation

Updated: Mar 29, 2017
  • Author: Stanley S Wang, JD, MD, MPH; Chief Editor: Yasmine S Ali, MD, FACC, FACP, MSCI  more...
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Presentation

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. [75]

Finally, a thorough review of systems may help to identify related problems, such as menstrual irregularities that can be seen in polycystic ovarian syndrome.

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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.

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