Metabolic Syndrome: An Updated Review on Diagnosis and Treatment for Primary Care Clinicians

Abstract

Objective: Metabolic syndrome is a cluster of cardiovascular risk factors (central obesity, hypertension, dyslipidemia, and insulin resistance) that affects between 12.5% and 31.4% of adults worldwide. It correlates with increased risks of cardiovascular disease, diabetes, cancer, and overall mortality in a dose-dependent fashion. This review aims to provide primary care clinicians an updated review of the evidence on metabolic syndrome, with a focus on treatment.

Design: Scoping evidence review.

Eligibility criteria: English-language studies of evidence Level I or II that focused on defining, diagnosing, and treating metabolic syndrome or its components.

Information sources: PubMed and Cochrane Database of Systematic Reviews.

Results: Though evidence is still lacking for improved outcomes with treating the syndrome per se, addressing its individual components reduces risks. Lifestyle changes like weight loss and increased physical activity are first line. Surgical options assist with weight loss for certain patients. Pharmacotherapies like glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter-2 inhibitors, statins, and antihypertensives also have efficacy.

Conclusions: Metabolic syndrome is an independent risk factor for many poor health outcomes. Its individual components should be treated with medication and behavioral changes to reduce cardiovascular risk and prevent diabetes and its complications. More research is needed on how to treat the syndrome itself. A diagnosis of metabolic syndrome may be useful for motivating patients toward lifestyle changes, though more research is needed on how to treat the syndrome versus its components.

Keywords: chronic disease; metabolic syndrome; preventive medicine; risk reduction behavior.

Figure 1.

PRISMA flow diagram. ^aConsider, if feasible to do so, reporting the number of records identified from each database or register searched (rather than the total number across all databases/registers). Source: Page MJ, et al. BMJ 2021;372:n71. doi: 10.1136/bmj.n71.