Metabolic Syndrome And Visceral Adipose Tissue
Chester J. Zelasko, Ph.D. | October 26, 2004

The obesity epidemic in the United States and Canada (and spreading to the rest of the world) has resulted in a cluster of conditions termed the Metabolic Syndrome or MetS for short. First described by Dr. Gerald Reaven over 30 years ago, MetS-associated conditions include hypertension, elevated blood lipids, diabetes, visceral adipose tissue, and most recently, polycystic ovary syndrome (PCOS). The question often posed by physicians and researchers is which condition comes first? While scientists may quibble, it seems apparent that an increase in abdominal fat, termed visceral adipose tissue (VAT), precipitates the onset of MetS.

How VAT contributes to so many conditions is the subject of active research. It probably begins with insulin resistance. In that condition, the body makes plenty of insulin but due to changes in the body’s insulin receptors, the insulin isn’t utilized to remove glucose from the bloodstream. As a result, the excess insulin stimulates the body to convert the glucose to fat, the fat is stored internally around the organs, and if a person continues to overeat, the cycle repeats. Excess fat in the bloodstream results in increased serum triglycerides. At this point, a variety of things can happen including high blood pressure, PCOS, and increased cholesterol levels. Over a number of years, MetS contributes to the development of full-blown heart disease and diabetes.

How do you know if you might have MetS? While there is no precise diagnostic tool, the Adult Treatment Panel III has listed several characteristics of MetS (1) that include waist measurements, several blood lipid measurements, blood pressure, and fasting blood glucose. However, in a recent seminar I attended, a leading VAT researcher narrowed it down to just two measurements which are going to be proposed as international standards. You are at risk for MetS is your waist measurement is greater than 35.5 inches and your fasting triglyceride level is higher than 175 mg/dl. That doesn’t mean that if you don’t meet both criteria you don’t have it and if you exceed both criteria you automatically have it.

What it means is that you should take action to reduce VAT to reduce the risk of the complications of MetS already discussed. How do you do that? While the syndrome is complex, the solution is not: Eat less and exercise more. But make sure you get a complete physical if you suspect you are at risk for MetS; as always, your healthcare professional should be your partner in your health.

Even more important than doing this for yourself, do it for your children who may be at risk as well. In a study published this month (October 2004), researchers found that almost 10% of all children aged 12-19 exhibit the symptoms of MetS (2). Ask yourself this question: what is the health outlook for a child who’s 12 and already has MetS? It’s time for action as individuals, as families, and as a nation. This is one catastrophe we can avoid if we get to work today.

References:
  1. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): Final Report. Bethesda, Md: National Heart, Lung, and Blood Institute; 2002.

  2. de Ferranti, SD et al. Prevalence of the Metabolic Syndrome in American Adolescents: Findings from the Third National Health and Nutrition Examination Survey. Circulation. 2004;110:2494-2497.
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