Metabolic Syndrome

What it is

Metabolic syndrome is a cluster of changes that tend to appear together and multiply the risk of diabetes and cardiovascular disease: increased waist circumference, elevated blood pressure, high glucose, high triglycerides and low HDL. The link between them is insulin resistance, fueled by excess abdominal fat and a sedentary lifestyle. In women, the syndrome is more common after menopause and in those with polyendocrine metabolic ovarian syndrome (SOMP). Because these changes reinforce one another, treating them in an integrated way is more effective than addressing each one separately. The endocrinologist organizes this care and tracks the progress of all the components over time.

Most common symptoms

• Waist circumference above 88 cm
• Elevated blood pressure on readings
• Fasting glucose above 100 mg/dL
• High triglycerides and low HDL on lab tests
• Fatigue, drowsiness and difficulty losing weight
• Dark patches on the neck and skin folds

Causes and risk factors

• Insulin resistance and excess abdominal fat
• A sedentary lifestyle and a diet high in ultra-processed foods
• Genetic predisposition
• Menopause and polyendocrine metabolic ovarian syndrome (SOMP)
• Poor sleep quality and chronic stress

How it is diagnosed

Diagnosis is clinical and is based on the presence of at least three of five criteria: increased waist circumference (above 88 cm in women), blood pressure of 130/85 mmHg or higher, fasting glucose of 100 mg/dL or higher, triglycerides of 150 mg/dL or higher, and HDL below 50 mg/dL. At the visit, the endocrinologist measures waist size and blood pressure, reviews blood tests and, when necessary, orders HbA1c, insulin, liver function and a body composition assessment. Family history and the calculated cardiovascular risk round out the evaluation and guide the intensity of treatment.

How we treat it at Femi Saúde

Treatment starts with reducing abdominal fat, which simultaneously improves blood pressure, glucose and lipids: losing 5% to 10% of body weight, a diet with less sugar and fewer ultra-processed foods, regular physical activity combining aerobic exercise and strength training, and adequate sleep. Any component that remains altered after these measures receives specific treatment, with medications for blood pressure, glucose or cholesterol as needed. Targets are reviewed at every visit, and throughout follow-up the endocrinology team at Femi Saúde monitors the progress of waist size, lab results and cardiovascular risk, adjusting the plan according to each patient's results and routine.

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