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Metabolic Syndrome Center Stage at AHA Scientific Sessions

Bruce Goldfarb

Several clinical research reports put metabolic syndrome in the spotlight during the American Heart Association (AHA) Scientific Sessions on Nov. 7 in New Orleans, La. Researchers say the risk of developing the condition is based on certain factors, and it can lead to further health complications.

While the concepts and definitions of metabolic syndrome continue to evolve (see sidebar on page 7, "Coming to Terms with Metabolic Syndrome"), few dispute that the condition is a growing public health menace.

According to one new study presented during the AHA sessions, young to middle-aged men with metabolic syndrome are 2.5 times more likely to develop atherosclerosis—even when other risk scores appear low—than their healthier counterparts.

"Metabolic syndrome is associated with the development of early atherosclerosis," says Kwame O. Akosah, MD, of Gundersen Lutheran Health System in La Crosse, Wis.

Akosah and colleagues performed carotid artery ultrasound on 246 subjects, with results stratified according to metabolic syndrome and diabetes status. Researchers found that many young and middle-aged men with metabolic syndrome had subclinical carotid atherosclerosis even when they had a low-risk Framingham score (an algorithm that estimates the risk of coronary heart disease).

"It appears that metabolic syndrome was the driving force behind atherosclerosis, not high C-reactive protein or diabetes," says Akosah.

For those who have not been diagnosed with metabolic syndrome, a second study presented suggests that maintaining a steady body mass index (BMI)—regardless of the starting point—is key to lowering the risk of developing the disease.

Donald M. Lloyd-Jones, MD, of Northwestern University's Feinberg School of Medicine, in Chicago, presented a study of 1,277 male and 1,208 female subjects revealing that those whose BMI increased more than 2 kg/m²—about 15 pounds on average—over a 15-year period had a substantially greater risk of developing metabolic syndrome, while those whose BMI remained stable or decreased had essentially unchanged risk levels.

"If you can maintain a stable BMI, you're much less likely to develop metabolic syndrome," says Lloyd-Jones. "It's clear from these data that if you're a young adult, maintaining your current weight is the place to start."

Maintaining a stable BMI may not be the only factor that lowers a person's risk of developing metabolic syndrome. Researchers also reported that alcohol consumption plays a role as well.

According to Amy Z. Fan, MD, PhD, and colleagues from the Prevention Research Center in Berkeley, Calif., the risk of metabolic syndrome increases the more a person drinks. Fan and colleagues reported that those at the highest levels of alcohol consumption have a 60% greater risk of developing metabolic syndrome than those at the lowest levels. The study also showed a pattern of heavy drinking early in life seems to add extra risk.

To read more about these studies, visit the "Scientific Conferences" page on AHA's web site at www.americanheart.org.

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