Metabolic Syndrome

(Syndrome X; Insulin Resistance Syndrome; Dysmetabolic Syndrome)


Metabolic syndrome is a mix of things that increase your risk of heart disease, diabetes, and stroke. There are at least 3 of these:

  • High blood pressure
  • High triglyceride levels
  • Large waistline
  • Low HDL (good) cholesterol
  • High fasting blood glucose

Coronary Artery Disease

Stereostatic Biopsy
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The cause of metabolic syndrome is not clear. Genes, diet, and activity level may all play a role.

Risk Factors

Metabolic syndrome is more common in people with:


There are no symptoms for metabolic syndrome itself. Too much weight in the belly is one risk factor.


Many of these tests are done as part of routine check ups. Metabolic syndrome is test results show 3 or more of these:

  • Fasting glucose level—100 mg/dL* (5.55 mmol/L) or higher
  • Triglyceride level—150 mg/dL (1.7 mmol/L) or higher
  • HDL cholesterol—40 mg/dL (1.0 mmol/L) or less in men and less than 50 mg/dL (1.3 mmol/L) in women
  • Blood pressure—130/85 millimeters of mercury (mm Hg) or higher
  • Waist that is 40 inches or more in men or 35 inches or more in women

*mg/dL = milligrams per deciliter of blood, mmol/L = millimoles per liter of blood


The goal of treatment is to cut the risk of heart disease and diabetes. Steps may treat issues that caused metabolic syndrome or other heart disease risk factors. Lifestyle changes may play a large role. Medicine may be needed if lifestyle changes are not enough to lower risk.

Lifestyle Habits

The first step is often lifestyle changes. This may include:

  • 30 to 60 minutes of exercise 5 or more days per week, should use effort level that leads to increase in heart rate and breathing
  • Healthy diet choices such as:
    • Whole grains, fruits, and vegetables
    • Lean meats, poultry, and fish
    • Low-fat or fat-free dairy products
    • Limit or avoid processed foods or other foods high in saturated and trans fats, sodium and added sugar
    • Proper portion sizes
  • Stop smoking
  • Weight loss—goal to decrease waist size below risk level and keep weight off

These steps can help to treat high blood pressure and high cholesterol. They can also affect problems with insulin which can lead to diabetes. These changes can make large changes for some people. Others may need medical care.


Medicine may be needed to treat factors that lead to metabolic syndrome. They may also decrease the risk of heart disease. Options include medicine to:

  • Lower blood pressure
  • Lower insulin resistance and risk of diabetes
  • Lower cholesterol and triglyceride levels
  • Lower clotting in the blood—a risk factor for heart disease and stroke


To decrease the risk of developing metabolic syndrome:

  • Eat a balanced diet.
  • Reach and keep a healthy weight.
  • Aim for at least 30 minutes of exercise most days of the week.


American Heart Association
National Institute of Diabetes and Digestive and Kidney Diseases


Canadian Cardiovascular Society
Canadian Diabetes Association


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Metabolic syndrome in adults. EBSCO DynaMed website. Available at: . Updated March 29, 2018. Accessed October 31, 2019.
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Last reviewed October 2019 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD
Last Updated: 10/31/2019

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