METABOLIC SYNDROME

Question 1

Definition of a patient with Metabolic Syndrome.

Answer 1

(1) Constellation of 3 or more of the following:
(a) Abdominal obesity
(b) Triglycerides 150mg/dl or higher
(c) HDL <40mg/dl for men or 50mg/dl for women
(d) Fasting glucose of 110mg/dl or higher
(e) Hypertension

Question 2

Diagnosis of a patient with Metabolic Syndrome.

Answer 2

(1) Generally detected on routine screening
(a) Height, weight, and blood pressure at each clinical encounter.
(b) Waist measurement if BMI >25
(c) Lipid screening: Some variation to societal guidelines for screening purposes in
patients 20-75 years old, every 5 years is reasonable (2018 American College of
Cardiology / American Heart Association)
(d) Fasting Glucose: American Diabetes Association recommends checking fasting
glucose or A1C every 3 years in patients with BMI at or greater that 25 with one
or more additional risk factors (family history, PCOS, hypertension,
hyperlipidemia, high risk ethnicity, cardiovascular disease).

Question 3

Significance of diagnosis of a patient with Metabolic Syndrome.

Answer 3

(1) Reminder to clinicians to screen for an correct more than chief complaint
(e.g. hypertension or hyperglycemia) which may lead to significant relative
risk reductions in coronary and cerebrovascular disease

Question 4

Management of a patient with Metabolic Syndrome.

Answer 4

(1) Counseling appropriate weight management and physical activity is
paramount.
(2) Diet modification if needed for improved weight (calories), glucose (simple
sugars), or blood pressure control (salt intake).
(3) Nutrition referral advised for tailored dietary counseling.
(4) Metformin may be considered if impaired fasting glucose is present.
(5) Blood pressure medications depending on comorbidities.