What Is Metabolic Syndrome?

Metabolic syndrome is a group of medical problems that put some children older than 10 years old at risk for heart disease and type 2 diabetes as adults. These problems are:

• too much belly fat (high waist measurement)
• high blood pressure (hypertension)
• high triglycerides
• low HDL cholesterol ("good cholesterol")
• high blood sugar

What Causes Metabolic Syndrome?

Being overweight is the main reason that people get metabolic syndrome. Excess weight causes insulin resistance. Normally, insulin helps glucose enter the body's cells. Insulin resistance happens when the body doesn't respond properly to insulin, making it harder for glucose to enter the cells. Insulin resistance and inflammation add to the problems linked to metabolic syndrome.

What Are the Signs & Symptoms of Metabolic Syndrome?

People with metabolic syndrome may have:

• high body mass index (BMI) and waist circumference 
• blood test results that show high triglycerides, low HDL cholesterol, or high fasting blood sugar
• acanthosis nigricans. This darkening of the skin in folds and creases, like the neck and armpits, is a sign of insulin resistance.

Other medical problems associated with metabolic syndrome and obesity include:

• fatty liver
• polycystic ovary syndrome (PCOS)
• obstructive sleep apnea

Who Gets Metabolic Syndrome?

Some normal weight people can have high blood pressure, diabetes, and heart disease. But most people with metabolic syndrome are overweight. In kids, as obesity gets worse, metabolic syndrome becomes more likely.

Obesity and the problems associated with metabolic syndrome tend to run in families. Other things that put someone at risk for metabolic syndrome include:

• not being physically active
• a high-carbohydrate diet
• smoking

How Is Metabolic Syndrome Diagnosed?

Doctors might suspect metabolic syndrome if an overweight or obese person has acanthosis nigricans or a family history of diabetes or heart disease. They may do:

• a BMI and waist measurement
• measure blood pressure
• blood tests, including a lipid panel, glucose test, and/or hemoglobin A1c

Because metabolic syndrome and obesity tend to go hand-in-hand, doctors might order more tests to look for other weight-related problems, like fatty liver, PCOS, and apnea.

How Is Metabolic Syndrome Treated?

Metabolic syndrome is treated by making positive lifestyle changes. Weight loss can bring about big improvements in blood pressure, blood sugar, and lipids. Slowing the rate of weight gain or maintaining weight in children who are still growing also will help.

Families can work with their health care provider, a dietitian, or a weight management program to create healthy habits. Recommendations include:

• limiting junk food and sugary beverages
• eating more fruit and vegetables 
• choosing whole grains
• reducing screen time
• being more physically active
• not smoking

When lifestyle changes aren't enough, children may need treatment for the medical problems, like hypertension. Doctors might recommend weight loss surgery for some teens with metabolic syndrome and severe obesity who do not respond to lifestyle changes.