What is metabolic syndrome?

Metabolic syndrome is a group of five risk factors, that when left untreated, increase the likelihood of developing heart disease, diabetes, and stroke. It may also be called syndrome X or insulin resistance syndrome.

The five risk factors are:

  • high blood pressure, including taking medicine to lower your blood pressure
  • high blood sugar levels (insulin resistance), or taking medication to lower your blood sugar
  • excess fat around the waist
  • high triglyceride levels, or taking medicine to lower your levels
  • low levels of good cholesterol or HDL, or taking medicine to manage low HDL

Having one of these risk factors does not mean that you have metabolic syndrome. However, having one will increase your chances of developing cardiovascular disease. Having three or more of these factors will result in a diagnosis of metabolic syndrome and will increase your risk of health complications including type 2 diabetes.

Metabolic syndrome is common. In the United States, over 40 percent of people over the age of 50 have this condition.

What are the risk factors for metabolic syndrome?

The risk factors for metabolic syndrome are related to obesity. The two most important risk factors are defined by the National Heart, Lung, and Blood Institute as:

  • central obesity, or excess fat around the middle and upper parts of the body
  • insulin resistance, which makes it difficult for the body to use sugar

There are other factors that can increase your risk for metabolic syndrome. These include:

  • age
  • family history of metabolic syndrome
  • not getting enough exercise
  • having obstructive sleep apnea, chronic kidney disease, or nonalcoholic fatty liver disease
  • being diagnosed with polycystic ovary syndrome

What are the signs and symptoms of metabolic syndrome?

If you have metabolic syndrome, you may not have any specific symptoms.

One sign that may be observable is a larger waistline or an apple-shaped body.

If you have high blood sugar, you may notice symptoms of diabetes, including increased thirst, blurred vision, headaches, and fatigue.

If you have one of the five risk factors of metabolic syndrome, talk with a doctor to determine whether you should be tested for the others.

How is metabolic syndrome diagnosed?

To diagnose metabolic syndrome, a doctor will need to perform several different tests. The results of these tests will be used to look for three or more signs of the disorder.

According to 2021 best practices, the tests and at-risk levels include:

  • Waist circumference. Doctors will measure your waist. A measurement of 40 inches for men or 35 inches for women is considered a risk factor.
  • Fasting blood triglycerides. To check fasting triglycerides, a lipid panel is performed after fasting. A level equal to or greater than 150 milligrams per deciliter (mg/dL) of blood indicates a risk factor.
  • Cholesterol levels. The lipid panel will also show doctors the levels of high density lipoprotein (HDL) and low density lipoprotein (LDL) in your blood. An HDL level of 40 mg/dL in men or 50 mg/dL in women is considered at risk.
  • Blood pressure. Systolic blood pressure in the range of 130 mmHg or higher or diastolic blood pressure at 85 mmHg or higher indicates you may be at risk.
  • Fasting glucose level. This blood glucose test is also performed after fasting. A reading of l00 mg/dL or greater is considered a risk factor.

You may have metabolic syndrome if three or more of these tests come back with a reading within the above ranges.

What are the causes of metabolic syndrome?

Having excess weight in your abdominal region can lead to fat accumulating in the liver and muscle cells.

Insulin resistance can develop. This is when your cells stop responding to insulin in the bloodstream. It can lead to higher insulin levels and blood sugar levels. If your blood sugar levels become too high, you can develop type 2 diabetes.

What are the complications of metabolic syndrome?

The complications that may result from metabolic syndrome are frequently serious and long-term (chronic). They include:

  • hardening of the arteries (atherosclerosis)
  • diabetes
  • heart attack
  • kidney disease
  • stroke
  • nonalcoholic fatty liver disease
  • peripheral artery disease
  • cardiovascular disease

If diabetes develops, you may be at risk for additional health complications, including:

  • eye damage (retinopathy)
  • nerve damage (neuropathy)
  • kidney disease
  • amputation of limbs

How is metabolic syndrome treated?

If you are diagnosed with metabolic syndrome, the goal of treatment will be to reduce your risk of developing further health complications.

A doctor may suggest:

  • a healthy diet
  • regular exercise, including aerobic exercise or resistance training
  • weight loss
  • medication
  • reducing other cardiovascular risks, such as by quitting smoking

Your doctor may recommend losing around 7 percent of your current weight and getting at least 30 minutes of moderate to intense exercise 5 to 7 days a week. This may help reverse the syndrome.

Medications for metabolic syndrome may include

What is the outlook for people with metabolic syndrome?

If symptoms are managed, people with metabolic syndrome can reduce their risks of developing serious health problems such as heart attack or stroke. The condition may be able to be reversed with weight loss or managed with a combination of diet, exercise, and medication.

Although symptom management will reduce health complications, most people with this condition have a long-term risk of cardiovascular disease. If you develop this condition, you may need to be monitored by your doctor to help prevent serious health problems such as heart attack and stroke.

How can metabolic syndrome be prevented?

Maintaining a healthy waist circumference and blood pressure and cholesterol levels reduce your risk for metabolic syndrome. Exercise and weight loss can aid in these efforts and decrease insulin resistance.

You can reduce your risk of developing metabolic syndrome with the following lifestyle changes:

  • Diet. Eat a healthy diet that includes fruits, vegetables, and whole grains. Avoid processed foods and those containing sugar and refined carbs.
  • Drink water. Avoid sugary beverages and substitute them for zero-calorie options like water and tea.
  • Exercise. Regular physical activity will reduce your blood pressure, blood sugar, and cholesterol levels.

Talk to a doctor before beginning an exercise program or radically changing your diet. They can help you find an option that is safe for you.

Regular physical exams may also help prevent metabolic syndrome. A doctor can measure your blood pressure and complete blood work. This may help detect the condition in the early stages, and prompt treatment can help reduce health complications over the long term.


Metabolic syndrome refers to a group of five risk factors that together can raise the risk for cardiovascular disease, insulin resistance, diabetes type 2, and stroke.

If you have metabolic syndrome, weight loss, regular exercise, a healthy diet, and medications may help reduce your risk for serious health complications.