By any name, the one undebatable thing is that these silent signs are being recognized as the most important public health problem in North America. They deliver as high a cardiovascular risk as high cholesterol, according to Jean-Pierre Despres, director of the lipid research center at Laval Hospital.
William Castelli, medical director of Framingham Cardiovascular Institute agrees, stating that Syndrome X is not detected because these people frequently have a total cholesterol below 200, indicating that the health threat is dangerous even if your total cholesterol is perfect.
Abdominal fat's effect
Syndrome X is the possible precursor from which both diabetes and cardiovascular disease spring. Castelli and Despres believe abdominal fat may be the switch that turns on the vicious metabolic cycle that leads to Syndrome X. Here's what happens:
Excess abdominal fat, which is different from regular body fat, is picked up by the circulatory system, increasing blood fats and LDL cholesterol. This makes cells less sensitive to insulin, resulting in insulin resistance. Diabetes may or may not occur at this point as excessive amounts of insulin are produced, affecting the kidney's sodium absorption. This causes sodium retention. Excess sodium leads to fluid retention, which causes increased blood pressure.
With increased blood pressure, artery walls become damaged and thickened as cholesterol deposits accumulate. This leads to coronary artery disease.
Excessive insulin (Insulin Resistance) seems to be at the heart of Syndrome X. However, insulin is difficult to measure, and the test is complicated, expensive and unpleasant. Researchers are working on a more practical solution. Until an acceptable insulin test is available, there are three measures that may indicate Syndrome X:
1) Waist measurement -
Women, greater than 38 inches, high risk.
Men, 40 inches or larger, high risk.
Keep in mind that these numbers are estimates.
2) Cholesterol Ratio -
Suspicious is a ratio of total cholesterol to HDL that is 5 or larger. For heart health, 3.5 is optimal.
3) Triglycerides - Many researchers feel that the suggested 200 milligrams per deciliter is too high. Castelli suggests a number above 150 paired with low HDL and a large waist pretty clearly indicates Syndrome X.
There may or may not be elevated blood sugar and high blood pressure.
Despite the serious health risks presented by Syndrome X, the remedy is simple, requiring a lifestyle fix, not medical treatment. It's a matter of exercising and adopting a low-fat, balanced diet. That's not a new message, but now you have more reason to heed it.
Jeanne Rhodes is owner and director of Rhodes Preventive Health Institute in Hagerstown. Write to her in care of The Herald-Mail Co., P.O. Box 439, Hagerstown,Md. 21741.