Metabolic Syndrome and Diabetes

He believes it may be responsible for at least half of all heart attacks. The growing obesity epidemic in the United States is contributing to the rising incidence of metabolic syndrome. which is threatening to reverse the overall reduction of CHD risk in the country, undoing decades of hard work. Factors that contribute to weight gain—physical inactivity, a high-fat diet, and junk food (often in the form of highly processed carbohydrates )—also contribute to metabolic syndrome.

Other signs of the syndrome include high levels of fibrmogen, a protein that increases the risk of blood clots. and increased PAI-1, a protein that slows the break down of those clots. In other words, if you have metabolic syndrome, it’s more likely that a clot will form where plaque has ruptured. A high level of lipoprotein (a) is another common characteristic. And some people with metabolic syndrome, though certainly not all, also have high LDL levels, compounding the problem.

The seriousness of metabolic syndrome as a CHD risk factor is clear. In a study of
4.483 people, those with metabolic syndrome were three times more likely to have
CHD, a stroke; ora heart attack as those without the syndrome. Another study found that for every 30 percent increase in insulin there is a 70 percent increase in the risk
of heart disease over a five-vear period.

Diabetes and Heart Disease

About 5 to 10 percent of people with metabolic syndrome will go on to develop type 2
‘iabetes, and that percentage is probably rising, given the current obesity epidemic.
Diabetes significantly increases heart disease risk. In fact, some 80 percent of people
with diabetes eventually die of CHD. Diabetes can contribute to an imbalance between
HDL and LDL. And like people with metabolic syndrome, diabetics tend to have smaller,
denser LDL particles, which lead to more plaque. To make matters worse, glucose
(blood sugar) latches onto lipoproteins, and sugar-coated LDL stays in the bloodstream
longer than normal LDL, presenting more opportunity for oxidation.

Glucose also binds to proteins on the surface of endothelial cells, damaging the
artery wall. This blood vessel assault is one of the factors that leads to blindness and
kidney damage in people with diabetes, and researchers suspect the same forces are at
work with CHD. But since the blood vessels leading to the eves and kidneys are smaller
and more delicate than those leading to the heart, that damage turns up sooner.

By the Numbers

There is no single test for metabolic syndrome, but if you have three or more of the
following factors, you probably have it: