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Metabolic Syndrome in the US

Metabolic syndrome, also referred to as syndrome X, is a term that is often used both inside and outside of the medical community, likely because its presence in society has become ubiquitous. According to a recent JAMA article, 35% of all US adults, and 50% of those 60 years of age or older, were estimated to have metabolic syndrome in 2011-2012. The authors noted that this high prevalence in the oldest age group is “a concerning observation given the aging US population.”

Prevalence is highest in women compared with men, and certain ethnic groups are more affected than others. In the US: Hispanics, non-Hispanic whites, and blacks are most commonly affected, in that order. While metabolic syndrome overall has increased since 2003, levels appear to have stabilized since 2007.

Metabolic syndrome is a cluster of conditions that increase one’s risk of heart disease, stroke and diabetes. At the root of this disorder is the body’s impaired utilization of glucose and insulin; a condition often referred to as insulin resistance. In a healthy system food is absorbed into the bloodstream in the form of glucose. This increase of sugar in the blood signals the pancreas to increase the secretion of insulin. Insulin then moves the glucose into the cell so it can be used for energy, and by doing so removes it from the bloodstream. Insulin resistance occurs when a normal amount of insulin is not able to open the cell “door” to let the glucose in. In response the body secretes even more insulin (hyperinsulinemia) in an attempt to lower the levels of sugar in circulation and maintain normal blood glucose levels.

Do you screen your patients for Metabolic syndrome? Metabolic syndrome is defined by having three or more of the following risk factors:

  • Insulin resistance (elevated fasting glucose)
  • Hypertension (BP > 130/85)
  • Abdominal obesity (Men > 40 inches; Women > 35 inches)
  • Prothrombic state (elevated fibrinogen or plasminogen activator inhibitor -1)
  • Inflammation (elevated CRP)
  • High Serum Lipids, especially triglycerides, LDL and reduced HDL

There are many strong connections between metabolic syndrome and hormone imbalances. Women with evolving or established insulin resistance often present with elevations in salivary androgen hormones (testosterone and/or DHEA), making it possible to detect potential blood sugar concerns prior to overt changes in bloodwork and before the resultant diagnosis of insulin resistance is made. In men, suboptimal testosterone levels predispose to metabolic syndrome, and restoration of testosterone levels may actually help reverse insulin resistance and ensuing blood sugar dysregulation. These altered androgen states as well as cortisol dysregulation and estrogen imbalances including estrogen dominance contribute to, and are perpetuated by, the abdominal obesity seen in metabolic syndrome. Because patients with metabolic syndrome are at an increased risk of developing cardiovascular disease, treatment should aim at decreasing this risk. Salivary hormone testing is a simple and accurate way to assess hormone imbalances associated with metabolic syndrome and can guide treatments that may help prevent the development of metabolic syndrome when used early on in the progression of this rampant condition. When coupled with lifestyle modifications including diet and exercise, salivary hormone testing may be used to help monitor effectiveness of treatment plans. Such modifications help with insulin resistance, blood pressure, and lipid abnormalities. Optimizing your patients’ hormone levels can provide additional support to help ease lifestyle transitions and create a targeted, successful treatment plan!

Learn more about how hormone and adrenal optimization can benefit your patients by attending Labrix Core Training or Labrix Advanced Workshop

References:

  • Aguilar M, Bhuket T, Torres S, Liu B, Wong RJ. Prevalence of the Metabolic Syndrome in the United States, 2003-2012. JAMA.2015;313(19):1973-1974. doi:10.1001/jama.2015.4260.
  • Study finds high prevalence of metabolic syndrome in US. The JAMA Network Journals. Public release: 9 May 2015.
  • “Treating Insulin and Metabolic Syndrome” handout, Labrix clinical services.

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