The risk factors associated with metabolic syndrome are dyslipidemia, hypertension, central obesity and hyperglycemia.1 But what exactly is each of these conditions? How are they defined? And what is their role in metabolic syndrome?

Central Obesity

Central obesity has an ethnic and country specific definition, but it generally refers to increased waist circumference due to fat deposition around a person’s abdominal area.2

Adipose tissue, or fat, is a highly active endocrine organ that affects the vascular system, the immune system and metabolism. Central adiposity has a tendency to increase the amount of inflammation within an individual. It is well accepted that cardiovascular disease (CVD) has an inflammatory profile.3 This is in part due to the fat cells in this area draining directly into the liver, which impairs its metabolism, causing inflammation. Moreover, the excess fat itself releases inflammatory mediators by overflowing out of the fat cells themselves. As a result, the immune system begins to clean up the debris, causing an inflammatory response.4  In the case of obesity, this chronic inflammation increases a person’s risk of atherosclerosis, stroke and heart attack.5


Dyslipidemia refers to the amount of HDL-cholesterol and triacylglycerols in the blood. A high triacylglycerol concentration (≥ 150mg/dL) or a low HDL concentration  (< 40mg/dL in men and < 50mg/dL in women) contributes to a diagnosis of metabolic syndrome. Inappropriate lipid profiles have been known to cause insulin resistance, leading to type 2 diabetes. 6

Hyperglycemia and Type 2 Diabetes

Abnormal glucose tolerance and hyperglycemia or its progression to type 2 diabetes similarly contribute to chronic inflammation and a patient’s overall risk of developing CVD. 6

Hyperglycemia is caused by insulin resistance, which begins when the body becomes less sensitive to insulin signals from the pancreas. To compensate for this, the pancreas initially begins to produce higher concentrations of insulin; however, this is only sustainable for a period of time before the cells responsible for producing insulin fail and lose their ability to produce insulin at all. Eventually, between the pancreas’s inability to produce insulin and the body’s increasing resistance to insulin, the body can no longer take glucose from the bloodstream after a meal and use it to make energy for our cells. This causes significant damage to the body. 6,7

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Individuals with a blood pressure of at least 140/90mmHg are considered to have hypertension and are at risk of cardio vascular disease. Both insulin resistance and elevated insulin levels have been linked to hypertension. People who are insulin resistant or have higher blood insulin levels are at a greater risk of developing hypertension.6

People with metabolic syndrome can reduce their risk of heart attack and stroke through management of each of the associated risk factors. Each risk factor has its own nuances for treatment; however, the commonality among them is that they can all be improved with positive lifestyle modifications.

  1. International Diabetes Federation (2006) “The IDF consensus worldwide definition of the Metabolic Syndrome”. Available at
  2. Despres, J.P. (2012) “Abdominal Obesity and Cardiovascular Disease: is inflammation the Missing Link?”, Canadian Journal of Cardiology, 28 (pp. 642-652)
  3. Ridker, P.M. (2007) “Inflammatory biomarkers and risks of myocardial infarction, stroke, diabetes, and total mortality: Implications for longevity”, Nutrition Reviews, 65 (S253-259)
  4. Després, J.P. (2006) “Abdominal obesity and metabolic syndrome”, Nature, 444 (pp. 881-887)
  5. Pai, J.K. (2004) “Inflammatory markers and the risk of coronary heart disease in men and women”, New England Journal of Medicine, 351(25) (pp. 2599-2610)
  6. Reaven, G.M. (2006) “The metabolic syndrome: is this diagnosis necessary?”, The American Journal of Clinical Nutrition, 83(6) (pp. 1237-1247)
  7. International Diabetes Federation (2006) “The IDF consensus worldwide definition of the Metabolic Syndrome”. Available at