X Syndrome/ Metabolic syndrome


Multiplex risk factor that arises from insulin resistance accompanying abnormal adipose deposition and function


  • Hypertension
  • Hyperglycemia
  • Hypertriglyceridemia
  • Reduced high-density lipoprotein cholesterol (HDL-C)
  • Abdominal obesity
  • Chest pains or shortness of breath:
  • Acanthosis nigricans, hirsutism, peripheral neuropathy, and retinopathy
  • Xanthomas or xanthelasmas: In patients with severe dyslipidemia
  • Increased thirst and urination, fatigue, and blurred vision
  • Large waist circumference is a visible sign
  • Central obesity


  • Overweight or obesity and inactivity
  • Insulin resistance
  • Unhealthy lifestyle
  • Hormonal imbalance

Risk Factors:

  • Age: metabolic syndrome increases with age
  • Race: United States, Mexican-Americans- at the greatest risk of developing metabolic syndrome
  • Obesity: Increases your risk of metabolic syndrome
  • Diabetes: people with diabetes more likely to have metabolic syndrome
  • Other diseases:cardiovascular disease, nonalcoholic fatty liver disease or polycystic ovary syndrome
  • High blood pressure

Diagnostic Tests:

  • Measurement of waist circumference
  • Fasting blood triglycerides
  • Cholesterol levels
  • Blood pressure
  • fasting glucose level
  • For complicated cases:
  • Electrocardiography (rest/stress ECG)
  • Ultrasonography (vascular, or rest/stress echocardiography)
  • SPECT or Cardiac PET

Differential Diagnosis:

  • Obstructive sleep apnea
  • Sleep-related breathing disorders
  • Reno vascular disease
  • Disorders of renin and aldosterone metabolism
  • Thyroid dysfunction
  • glucagonomas and pheochromocytomas
  • Chronic liver disease
  • Cushing syndrome
  • Congenital adrenal hyperplasia


  • A glucose tolerance test
  • Lifestyle changes
  • Medications to reduce your blood pressure, cholesterol, and/or blood sugar
  • Treatment-to reduce the risk of coronary heart disease
  • Treatment-to prevent the onset of type 2 diabetes
  • Treatment of associated obstructive sleep apnea


  • Medications might be given to:
  • Decrease chance of having a heart attack or dying suddenly
  • Lower blood pressure
  • Prevent blood clots, which can lead to heart attack or stroke.
  • Reduce heart’s workload and relieve symptoms of coronary heart disease
  • Elevated LDL-C levels: Statins
  • Decreased HDL-C levels: Consider niacin
  • Elevated triglyceride levels: Consider niacin, fibrates, and omega-3 fatty acids
  • Hyperglycemia: Insulin-sensitizing agent, such as metformin

Lifestyle Management:

  • Lifestyle change and weight loss
  • Diet and exercise
  • Having regular physical exams
  • Regular physical activity
  • maintaining a healthy weight
  • Restricting the overall dietary carbohydrate intake
  • Stopping smoking
  • Managing stress