Metabolic Syndrome

Metabolic syndrome (also known as syndrome X) is a group of risk factors that can cause serious chronic conditions such as heart disease and diabetes. If you are overweight, have high blood pressure and high levels of sugar or fats in your blood, you may suffer from metabolic syndrome.

You have the metabolic syndrome if you have 3 or more of the following:

• waist circumference > 90 cm in men and 80 cm in women
• triglyceride level of 1.7 mmol/l or more
• high density lipoprotein (HDL) cholesterol of 1.0 mmol/l or less in men, and 1.3 mmol/l or less in women
• blood pressure of 130/85 mmHg or more, or on treatment for high blood pressure
• fasting glucose level of 6.1 mmol/l or more, or on treatment for diabetes

​​The only obvious sign is a large waistline with an “apple-shaped” body figure. Most of the conditions linked to metabolic syndrome may be silent.

• Age. The prevalence of metabolic syndrome increases with age.
• Race. In Singapore, there is a higher proportion of metabolic syndrome among the Indians and Malays.
• Overweight/Obesity. A Body Mass Index (BMI) of 23 and above increases your risk of metabolic syndrome.
• Family history of diabetes. Women with high blood glucose during pregnancy also have greater risk of getting metabolic syndrome.
• ​Other medical conditions. People with high blood pressure, lipid disorders, or psoriasis have higher chance of developing metabolic syndrome

The more risk factors you have, the higher your risk of getting heart disease. If you have all of the risk factors, you are 6 times as likely to get heart disease.

If you adopt a sedentary lifestyle and become obese, you are also likely to have a higher risk.

​​Patients with psoriasis have an increased risk for the metabolic syndrome. They are twice as likely to have the metabolic syndrome compared with healthy individuals.

The most common feature of the metabolic syndrome among psoriasis patients are : abdominal obesity, followed by high triglyceride levels and low levels of “good” high-density lipoprotein (HDL) cholesterol.

In patients with severe psoriasis, they have nearly 3 times increased risk of dying from heart disease.

Smoking and alcohol intake also increases the risk of heart disease.

Only about 10% of people with psoriasis had no features of metabolic syndrome.

​​In psoriasis, there is chronic inflammation of the skin and an imbalance in the skin’s immune system.

Chronic inflammation can also contribute to heart disease, development of hypertension and diabetes.

Thus patients with psoriasis can be predisposed to heart disease and metabolic syndrome.

1. Consult your doctor for advice on screening for metabolic syndrome.
• Check waist circumference
• Measurement of blood pressure
• Blood tests for cholesterol and glucose levels

(Overnight fasting of 8 hours is required for cholesterol and glucose tests)

2. Stop smoking.
• Smoking cessation counselling is available in NSC. Please ask the doctor for more information.
3. Avoid alcohol abuse.

Since physical inactivity and excess weight are the main risk factors to developing metabolic syndrome, getting more exercise and losing weight can help reduce the risk or prevent the associated complications.

Medications may be prescribed to manage some of the underlying diseases such as hypertension, abnormal cholesterol levels and diabetes.

​​Some of the ways you can reduce your risk include:

1. Exercise

The amount and type of exercise depends on your fitness level. You should work towards the goal of walking for 30 to 60 minutes at least 5 days a week. If you are already exercising regularly, consider adding resistance exercises (e.g. carrying low weight dumbbells) to build muscle strength.

2. Diet​

Start by eating fewer calories, eating less at each meal and avoiding dessert or food cooked using unhealthy methods.

Try to eat less saturated fat, have smaller portions or leaner cuts of meat.

Eat more whole grains and include fruits and vegetables in your diet. Every individual should have at least 2 servings of fruit and two servings of vegetables daily.

Small changes like these will bring you huge benefits to your health so start making the changes today.