WHAT IS METABOLIC SYNDROME? 

Metabolic syndrome is a bundle of cardiometabolic risk factors that develop in common genetic and surrounding environments, characterized by waist circumference thickness, high blood pressure, qualitative and quantitative disorders in blood lipids, and high blood sugar. People with metabolic syndrome are 5 times more likely to develop type 2 diabetes and 2 times more likely to develop atherosclerotic cardiovascular disease than those without metabolic syndrome. Non-alcoholic fatty liver disease, polycystic ovary syndrome, sleep apnea syndrome, gallstones, gastroesophageal reflux, depression and asthma are among the tables associated with metabolic syndrome. High blood sugar, hypertriglyceridemia, low HDL cholesterol, high hepatic transaminase, hyperuricemia, in addition to classical findings such as microalbuminuria, elevated CRP and plasminogen activator inhibitor-1 are among the laboratory findings of metabolic syndrome. Considering the metabolic syndrome, which is accepted as a global epidemic, as a clinical entity will be beneficial in identifying high-risk individuals for the development of type 2 diabetes and atherosclerotic cardiovascular disease and determining common preventive approaches. 

Diagnosis of Metabolic Syndrome

Metabolic syndrome has different definitions for different organizations. The main components of these definitions are waist circumference, insulin resistance, high blood pressure and dyslipidemia (high triglyceride, low HDL cholesterol). The most recently agreed-upon diagnostic criteria for metabolic syndrome; increased waist circumference (society and country specific), high triglyceride, low HDL cholesterol, high blood pressure and high fasting blood glucose. The presence of at least 3 of these parameters is essential for diagnosis.

Why Is the Frequency of Metabolic Syndrome Increasing?


It is thought that the high prevalence of metabolic syndrome components such as hypertension, glucose metabolism disorder and dyslipidemia may play a role in the increase in the frequency of metabolic syndrome, as well as the increase in the frequency of abdominal obesity triggered by physical inactivity, sedentary lifestyle and overnutrition. In the PURE Turkey Health Study, it was observed that Turkish adults spent about 6 hours a day sitting on weekdays and weekends, without distinction between rural and urban areas, and their daily energy intake was found to be as high as 2483.7 kcal. These findings suggest that an impaired lifestyle is the most important factor in the increase in metabolic syndrome and abdominal obesity in our population. 


What about the waist circumference?

Increasing data reveal that waist circumference thickness is one of the most important predictors of cardiometabolic risk. According to IDF criteria (waist circumference limit >94 cm for men and >80 cm for women) in our country, the frequency of waist circumference was 73.8% in women and 43.2% in men.  


The frequency of metabolic syndrome is increasing rapidly: how should we take precautions?

Lifestyle regulation is the most important and effective approach in the prevention and treatment of metabolic syndrome. 

Exercise:  Regular exercise reduces body weight and fat ratio, lowers HbA1c, LDL cholesterol and triglycerides, and increases HDL cholesterol. Recommended exercises include swimming, cycling, brisk walking and jogging. For this purpose, it is recommended to do these moderate-intensity exercises for not less than 30 minutes a day, most days of the week, ideally every day. In the Diabetes Prevention Study, a 7% weight loss with diet and moderate-intensity physical activity was shown to reduce the development of metabolic syndrome by 41%.

Nutrition: Regulation of nutrition is effective not only in the treatment of obesity, but also in the correction of blood pressure, glycemia and lipid profile, and in the prevention of diabetes and cardiovascular complications. A diet restricted from saturated fats and rich in complex carbohydrates is a recommended diet model for people with metabolic syndrome. Recently, it has been reported that balanced diet models such as the Mediterranean diet are associated with a decrease in the frequency of metabolic disorders such as obesity, dyslipidemia and high blood pressure, as well as coronary heart disease and different types of cancer. The Mediterranean diet is a diet rich in fiber, complex carbohydrates and monounsaturated fats such as vegetables, fruits, legumes, olive oil, walnuts, hazelnuts, grapes, and low in saturated fats. It has been shown that the Mediterranean diet has a positive effect on blood lipid profile (especially HDL cholesterol and oxidized LDL cholesterol), endothelial function and insulin resistance, reduces the risk of thrombosis and lowers plasma homocysteine ​​levels, as well as a decrease in body fat. It has been shown that the Mediterranean diet reduces the development of MetS by 20%, regardless of age, gender, physical activity, lipid and blood pressure levels.