Metabolic syndrome
A cluster of simultaneous risk factors (large waist, high blood pressure, high blood glucose, high triglycerides, low HDL) that multiplies the risk of diabetes and cardiovascular disease.
Metabolic syndrome is not a single disease but a cluster of disturbances. It is diagnosed by the presence of at least 3 of the 5 criteria:
- Large waist circumference (>94 cm men, >80 cm women in Europe)
- Triglycerides ≥ 1.5 g/L
- Low HDL (<0.40 g/L men, <0.50 women)
- Blood pressure ≥ 130/85 mmHg
- Fasting blood glucose ≥ 1.0 g/L
An original angle (visceral fat at the centre): the common thread of metabolic syndrome is visceral fat, the fat that builds up around the organs (liver, pancreas, intestines), different from subcutaneous fat (under the skin).
This visceral fat is not simply inert storage: it is an active endocrine organ that secretes pro-inflammatory molecules (cytokines) and disrupts metabolism. It causes insulin resistance, chronic inflammation and lipid imbalance.
Hence a paradox: you can be « slim » (normal weight) yet have too much visceral fat (the TOFI phenotype: Thin Outside, Fat Inside). Waist circumference is a better indicator than weight or BMI.
The good news: visceral fat is the first to melt away with exercise and a better diet. A few kilos lost (especially through physical activity) disproportionately reduce visceral fat and improve every marker.