Metabolic syndrome

Metabolic syndrome, sometimes called syndrome X, is a group of health problems that together raise the risk of heart disease, stroke, and type 2 diabetes. Signs may include high blood pressure, elevated blood sugar (hyperglycemia), and high blood cholesterol levels. This condition is becoming more common and is often linked to excess belly fat and lifestyle factors like poor diet and lack of physical activity. 

Penn Medicine is home to metabolic specialists with wide-ranging expertise who collaborate with your primary care team and each other to provide seamless, coordinated care for metabolic syndrome and related conditions. 

Most metabolic syndrome symptoms are silent, which means they don’t cause noticeable changes. Some people may experience symptoms from associated conditions like high blood sugar (increased thirst, frequent urination) or high blood pressure (headaches, dizziness), but these conditions may also be symptom-free. High triglycerides or low HDL cholesterol will show up on routine blood tests but rarely cause symptoms. The most visible sign of metabolic syndrome is a large waistline or “apple-shaped” body.

Metabolic syndrome develops from a mix of genetics, lifestyle, and hormonal changes. The risk of metabolic syndrome increases after age 40, and it rises steadily with age. It’s most common in adults over 60. Long-term use of medications like steroids, antipsychotics, or some blood pressure medicines may contribute by affecting weight, insulin sensitivity, or cholesterol levels. 

Other common metabolic syndrome risk factors and causes include: 

• Physical inactivity 
• A diet high in processed foods, sugar, and unhealthy fats 
• A family history of type 2 diabetes, high blood pressure, or early heart disease 
• Insulin resistance (the body does not respond normally to insulin) 
• Hormonal disorders such as polycystic ovary syndrome (PCOS), Cushing’s syndrome, or an underactive thyroid

Doctors diagnose metabolic syndrome through a combination of health history, physical examination, and laboratory tests such as blood and lipid panels. Typically, a person is considered to have metabolic syndrome if they have at least three of the following: 

• Excess abdominal fat (central obesity) 
• High blood pressure (hypertension)  
• High fasting blood sugar 
• High triglyceride level 
• Low HDL (“good” cholesterol)

Metabolic syndrome treatment focuses on lowering the risks of heart disease, stroke, and type 2 diabetes. The first step is usually lifestyle change, supported by medical therapy when needed. Treatment options may include: 

• A heart-healthy eating plan 
• Increased physical activity 
• A weight loss program  
• Medications to manage blood pressure, blood sugar, or cholesterol  
• Support to quit smoking

Many cases of metabolic syndrome may be prevented by building and maintaining healthy habits over time, like eating a balanced diet, increasing physical activity, and managing weight. Additional steps to help reduce risk include limiting alcohol, getting routine checkups (to monitor blood pressure, blood sugar, and cholesterol), and making small, manageable changes in daily habits. Even simple adjustments, such as taking short walks, reducing sugary drinks, or improving sleep, can reduce your risk of developing metabolic syndrome and make a real difference in your long-term health. 

Penn Medicine provides expert diagnosis and treatment for metabolic syndrome and related diseases. Our coordinated approach addresses both the root causes of metabolic syndrome and the long-term health risks, helping you take control of your health and improve your quality of life. We offer access to: 

• Multidisciplinary care teams across endocrinology, cardiology, weight management, and nutrition 
• Advanced and individualized metabolic syndrome treatments, including lifestyle programs, medications, and surgical options 
• Expert support for related conditions like obesity, type 2 diabetes, and heart disease 
• Clinical research and the latest evidence-based therapies