Metabolic Syndrome

Exam Cram

• Metabolic Syndrome describes a syndrome of symptoms and conditions from common risk factors around the effects of high weight and poor diet

• Presentation: central obesity, immobility, reduced exercise tolerance, low mood

• Diagnosis: (3/5)- high waist circumference, triglycerides, HDL cholesterol, BP or blood sugar

• Management: exercise, diet, GLP-1 agonists

Outline

Background

Risk factors

• Environment

  • Poor diet- high saturated fat, sugar, salt; malnutrition

  • Lack of exercise

• Genetic component

• UK 2026: population: 1/3 healthy weight, 1/3 overweight, 1/3 obese; 1% underweight

Diagnosis

Diagnostic criteria: NCEP ATP III, > 2 factors

• Waist circumference > 102cm (M) or > 88cm (F)

• Triglycerides > 150mg/dL

• HDL cholesterol < 40mg/dL (M), < 50mg/dL (F)

• BP > 130/85

• Blood sugar (fasting) > 11.0

Differentials

• Cushing's Syndrome 

Metabolic Conditions

Core

• Obesity

• Hypertension

• MASLD (Metabolic Liver Disease) 

• T2DM (Type 2 Diabetes Mellitus) 

• Hyperlipidaemia

Secondary

• Coronary Artery Disease , Stroke , 

• Venous Thrombotic Disease (PE, DVT)

• Peripheral Vascular Disease,

• Cancers- breast, bowel, endometrial

• PCOS (Polycystic ovary syndrome) 

• Osteoarthritis & Gout 

• Urinary Stones & Biliary Stone Disease 

• Irritable Bowel Syndrome & GORD  

• Obstructive Sleep Apnea (OSA)

• IIH (Idiopathic Intracranial Hypertension) & Alzheimer's Disease 

• Depression, anxiety disorders, bulimia nervosa

Management

Chronic

1. Lifestyle

   • Exercise regimes

   • Diet

2. Medications

   • GLP-1 agonists

3. Surgeries

   • Gastric-bypass

Discussion

Mortality

Obesity is associated with reduced life expectancy, particularly at the severe spectrum. Severe oibesity (BMI 30-35) was associated with a reduction in life expectancy from 5-20yrs, from increased rate of myocardial infarction, stroke and cancers [1]. 

Resources and References

1. https://pmc.ncbi.nlm.nih.gov/articles/PMC5401682/

Written in 2025