Cardiometabolic syndrome (CMS)
Cardiometabolic syndrome (CMS), also known as metabolic syndrome, is a cluster of metabolic disorders that significantly increase a person’s risk of cardiovascular diseases and type 2 diabetes. CMS is a combination of conditions such as insulin resistance, impaired glucose tolerance, dyslipidemia (abnormal cholesterol levels), hypertension (high blood pressure), and central adiposity (excess fat around the waist).
CMS is unfolding as a new topic of cardiology research because it highlights the intricate and essential relationships among obesity, insulin resistance, and cardiovascular well-being. Understanding CMS and its causes, as well as exploring new ways to diagnose and treat it, is essential for a brighter public health future. Advancements in our knowledge of CMS empower the cardiology field to evolve into a holistic, individualized cardiovascular care domain.
Prevalence
The global rate of CMS continues to rise. Currently, about 1 in 3 adults have metabolic syndrome. The National Health and Nutrition Examination Survey (NHANES) found that in 2007–2014, 35.3% of men and 33.3% of women had CMS. In the United States, the prevalence of CMS increases with age and is higher in Black women (40%) than in Black men, White women, or White men.
Key Components
The main components of CMS include:
- Insulin Resistance
A condition where the body’s cells do not respond effectively to insulin, which increases a person’s blood glucose level. Insulin resistance can make the liver produce more of the bad cholesterol and fats that lead to increased serum triglycerides and LDL levels. Insulin resistance also leads to microvascular damage and endothelial dysfunction, both of which increase the risk of developing hypertension and atherosclerosis (hardening of the arteries). - Impaired Glucose Tolerance
Higher-than-normal blood sugar levels that do not yet qualify as diabetes. - Dyslipidemia
Abnormal levels of lipids in the blood, including high levels of triglycerides and LDL (“bad”) cholesterol and low levels of HDL (“good”) cholesterol. - Hypertension
Persistently high blood pressure. - Central Adiposity
Excess fat accumulation around the abdomen, often measured by waist circumference.
Risk Factors
Several risk factors contribute to the development of CMS, including:
- Genetic Predisposition
- Family History of Diabetes, Cardiovascular Diseases, or Metabolic Disorders
- Dyslipidemia
In CMS, dyslipidemia is a combination of high triglycerides, LDL (“bad” cholesterol), and low HDL-C levels. - Lack of Sleep
Can lead to problems with how the body absorbs nutrients from food. - Occupation
Certain jobs can put a person at higher risk of CMS. For example, shift workers often have misaligned circadian clocks, which also affect metabolism and how the body absorbs nutrients.
Lifestyle Factors in Cardiometabolic Syndrome
Poor diet, physical inactivity, smoking, and excessive alcohol consumption are the main lifestyle drivers of cardiometabolic syndrome.
- Obesity and Overweight
Overweight and obesity—especially central obesity—are common in people with CMS. Central obesity is believed to contribute to the pro-inflammatory state that is part of CMS. Overeating leads to changes in fat cells that cause inflammation and central obesity. It also increases blood glucose levels and insulin resistance. - Age and Ethnicity
Older age and certain ethnic backgrounds (such as African American and Mexican American) are associated with a higher risk of CMS. - Hormonal Imbalances
Conditions like polycystic ovary syndrome (PCOS) and menopause can also contribute.
Health Consequences of Cardiometabolic Syndrome
Individuals with CMS are at significantly increased risk for:
- Cardiovascular Diseases
Including heart attacks, strokes, and atherosclerosis (hardening of the arteries) - Type 2 Diabetes
Due to impaired glucose tolerance and insulin resistance - Kidney Disease
Chronic kidney disease (CKD) can result from the same risk factors that contribute to cardiometabolic syndrome. - Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)
Also called non-alcoholic fatty liver disease (NAFLD), this is an accumulation of fat in the liver that is unrelated to alcohol consumption. It often co-occurs with other metabolic disorders such as high cholesterol, obesity, and diabetes.
Prevention and Management
Preventing and managing cardiometabolic syndrome involves a combination of lifestyle changes and medical treatments:
Lifestyle Modifications
- Diet
Adopting a heart-healthy diet rich in whole grains, fruits, vegetables, and fish - Exercise
Regular physical activity to maintain a healthy weight and improve metabolic health - Weight Management
Achieving and maintaining a healthy body weight - Smoking Cessation
Quitting smoking to reduce cardiovascular risk - Reducing Alcohol Intake
Limiting alcohol consumption to moderate levels
Medical Treatments
- Medications
To control blood pressure, cholesterol levels, and blood sugar - Regular Monitoring
Frequent health check-ups to monitor and manage risk factors effectively
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