Syndrome X – the Hidden Epidemic


A cluster of independent risk factors puts you at increased of death. Is the metabolic syndrome real or just sick statistics?

Syndrome X sounds like the title of a futuristic novel, but the metabolic syndrome, as it is more commonly called, is now consi

dered to be a real medical entity.

The exact definition of what it is seems to vary among the medical elite, but it does seem to involve a number of illnesses and symptoms that generally make us less healthy. So what makes them cluster if they do indeed occur together to make matters worse?

Obesity is one of the clusterers, but it is not your usual type of obesity. There is good obesity and bad obesity. Or perhaps to be more PC there is healthy obesity and unhealthy obesity. Independent of actually being overweight some obese people are more healthy than others. So being obese is not all bad then.

Confused? Well how about talking about apples and pears? If you look like an apple you are worse off then if you look like a pear.

It is not the weight you carry per se but where the weight is distributed that is important. No longer is BMI considered to be an adequate measure of risk, but waist circumference measures of abdominal visceral fat that seem to be more predictive of ill health.

So a thin legged and thin armed man who wears a high belt above a burgeoning beer belly is no longer safe. He is the unhealthy apple. 40 inches in men and 35 inches in men are the figures that you should avoid exceeding. So get the tape measure out.

Suddenly from nowhere has emerged in the last few years a new organ. It has appeared in the arms of a TV medic on the Oprah Winfrey show – a yellow fatty thing. It is called the omentum, and it is now being classed as the new devil. If you have too much fat in your omentum, it is not good and you may be prone to more infections and cancer.

So apart from the omentum and a fat belly what else puts you at risk?

Type 2 diabetes is an element of the metabolic syndrome. This is a rather obvious one. If you have type 2, then you are at a much higher risk of heart disease and a whole lot of other nasty conditions from kidney to nerve damage to gangrene. As well as this you will have insulin resistance, which is the main reason why diabetics are likely to be more obese.

So if you are obese you are more likely to be diabetic and if you are diabetic you are more likely to be obese. This is how the metabolic syndrome clusters.

High blood pressure or hypertension is another one that is associated with the metabolic syndrome. Persistent high blood pressure is associated with an increased risk of stroke, heart-attack, heart failure and the occurrence of aneurysms – dangerous bulges in the blood vessel wall. Even a moderately high blood pressure may shorten the lifespan.

However, high blood pressure in one person may not guarantee the same risk as high blood pressure in another. And what is high blood pressure? Is it three consecutive high measurements measured in a GP’s clinic or in a cardiologist clinic with the clinician wearing a white coat? Or should we be talking about ambulatory 24-hour measurements in a patient’s home when they are going about their daily activities? Surely this would be more accurate.

Or should we be also looking at the fluctuations in blood pressure between high and low, particularly in the elderly? And few talk about low blood pressure of people who are on blood pressure tablets? What about that? Does that carry risks too that might be associated with the metabolic syndrome?

There are two measurements in blood pressure – a high and a low. The systolic is the higher value and the diastolic is the lower measurement. Primary hypertension has no other cause whereas secondary hypertension can be due to obesity. It is not yet known how significant just having a higher than normal diastolic measurement is, but it is thought that high systolic pressures become more important over 50 years of age.

And then to make things really complicated there are the lipids. Low serum HDL or good cholesterol and high blood triglycerides are thought to be cluster with the metabolic syndrome.

Other things have been putatively included under the system x umbrella. Having sticky blood, snoring, dodgy kidneys and the fatty liver have all been implicated in the cluster of symptoms that are interconnected and potentially more damaging in unison than in isolation.

This kind of clustering of individual symptoms makes you wonder does something like tooth decay have anything to do with it.

What can we do about this horrendous metabolic cluster that seems as inevitable as death as we age? Exercise is good. Eat healthily. And ‘don’t worry, be happy,’ as stress may impact on any other risk factors you may have. That seems like good advice.

I am off now to lower my belt and take it in a notch.

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One Response to “Syndrome X – the Hidden Epidemic”

  1. Thank you for this post! I looked all around for an explanation of syndrome x and yours was by far the clearest and most concise! Thank you!

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