Metabolic syndrome is the name given to a combination of cardiovascular risk factors. These include hyperinsulinaemia, impaired glucose tolerance, hypertension, central obesity and dyslipidaemia. People with metabolic syndrome have a high risk of developing type 2 diabetes, non-alcoholic fatty liver disease, and vascular conditions including coronary artery disease, peripheral vascular disease, and stroke. Central obesity can predispose to sleep apnoea and restrictive lung disease. For many years, it has been taught that the underlying mechanism of metabolic syndrome is insulin resistance secondary to obesity and inactivity, however, this somewhat simplistic model fails to accurately describe the complex interaction between three key factors: glucose, insulin and cortisol. This article will explain our current understanding of metabolic syndrome and how to treat it.
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