Metabolic  syndrome is the name for a group of risk factors that raise your risk for heart disease and other health problems, such as diabetes and stroke. The term "metabolic" refers to the biochemical processes involved in the body's normal functioning. Risk factors are traits, conditions, or habits that increase your chance of developing a disease.

A number of "metabolic" diseases and conditions are associated with severe or morbid obesity including Type 2 Diabetes, hypertension, high cholesterol, non-alcoholic fatty liver disease, and obstructive sleep apnea. The gastrointestinal (GI)  tract and small bowel  play  critical roles in the regulation of blood sugar levels, fat metabolism, and in the control of appetite and body weight. Metabolic syndrome can also lead to coronary heart disease (CHD), a condition in which a waxy substance called plaque (plak) builds up inside the coronary arteries. Plaque hardens and narrows the arteries, reducing blood flow to your heart muscle. This can lead to chest pain, a heart attack, heart damage, or even death.

Metabolic Bariatric Surgery and Type 2 Diabetes

Metabolic bariatric surgery can dramatically improve or cure diabetes in some obese patients including a group that does not strictly meet the criteria of morbid obesity. Metabolic surgery can normalize blood glucose levels and allow for a discontinuation of insulin therapy. Curing diabetes through metabolic surgery has been a stunning and welcome development for a disease that has historically been considered chronic and irreversible.

Recent data suggest that that operations used to treat morbid obesity, diabetes and other metabolic disorders appear to cure these diseases in some patients, not simply by inducing weight loss, but though direct changes to the anatomy. This widely reported development has focused new attention on the treatment of diabetes.


Why UCSF for Metabolic Bariatric Surgery

The multidisciplinary bariatric program at UCSF offers individualized treatment plans to patients with diabetes and other metabolic conditions. These treatments include laparoscopic gastric bypass, Lap-Band, and sleeve gastrectomy. Using minimally invasive techniques and small abdominal incisions, patients experience less postoperative pain and scarring, a faster recovery and a more rapid return to normal daily activity. 

Metabolic Risk Factors

The five conditions described below are metabolic risk factors. You can have any one of these risk factors by itself, but they tend to occur together. You must have at least three metabolic risk factors to be diagnosed with metabolic syndrome.

  • A large waistline. This also is called abdominal obesity or "having an apple shape." Excess fat in the abdominal area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the hips.
  • A high triglyceride level (or you're on medicine to treat high triglycerides). Triglycerides are a type of fat found in the blood.
  • A low HDL cholesterol level (or you're on medicine to treat low HDL cholesterol). HDL sometimes is called "good" cholesterol. This is because it helps remove cholesterol from your arteries. A low HDL cholesterol level raises your risk for heart disease.
  • High blood pressure (or you're on medicine to treat high blood pressure). Blood pressure is the force of blood pushing against the walls of your arteries as your heart pumps blood. If this pressure rises and stays high over time, it can damage your heart and lead to plaque buildup.
  • High fasting blood sugar (or you're on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes.

Overview

Your risk for heart disease, diabetes, and stroke increases with the number of metabolic risk factors you have. In general, a person who has metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone who doesn't have metabolic syndrome.

Other risk factors, besides those described above, also increase your risk for heart disease. For example, a high LDL cholesterol level and smoking are major risk factors for heart disease, but they aren't part of metabolic syndrome.

Having even one risk factor raises your risk for heart disease. You should try to control every risk factor you can to reduce your risk.

The chance of developing metabolic syndrome is closely linked to overweight and obesity and a lack of physical activity. Insulin resistance also may increase your risk for metabolic syndrome.

Insulin resistance is a condition in which the body can't use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where it's used for energy. Insulin resistance can lead to high blood sugar levels, and it's closely linked to overweight and obesity.

Genetics (ethnicity and family history) and older age are other factors that may play a role in causing metabolic syndrome.

Outlook

Metabolic syndrome is becoming more common due to a rise in obesity rates among adults. In the future, metabolic syndrome may overtake smoking as the leading risk factor for heart disease.

It is possible to prevent or delay metabolic syndrome, mainly with lifestyle changes. A healthy lifestyle is a lifelong commitment. Successfully controlling metabolic syndrome requires long-term effort and teamwork with your health care providers.