Metabolic syndrome: diagnostic criteria, cardiovascular risk and treatment | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"The metabolic syndrome combines abdominal obesity, hypertension, dyslipidemia and hyperglycemia, amplifying the risk of cardiovascular disease and diabetes. IDF criteria, waist circumference, statins and management in Quebec.\">\n<meta name=\"keywords\" content=\"syndrome m\u00e9tabolique, syndrome m\u00e9tabolique crit\u00e8res, syndrome m\u00e9tabolique traitement, tour de taille syndrome m\u00e9tabolique, r\u00e9sistance insuline syndrome m\u00e9tabolique, syndrome m\u00e9tabolique diab\u00e8te, syndrome m\u00e9tabolique cardiovasculaire, ob\u00e9sit\u00e9 abdominale, syndrome m\u00e9tabolique IDF, syndrome m\u00e9tabolique Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n@import url('https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap');\n\n.co-wrap * {\n font-family: 'Poppins', sans-serif;\n box-sizing: border-box;\n}\n.co-wrap {\n max-width: 1100px;\n margin: 0 auto;\n padding: 30px 0 60px;\n margin-top: 10px;\n}\n.co-label {\n font-family: 'Cinzel', serif;\n font-size: 14px;\n font-weight: bold;\n letter-spacing: 1px;\n text-transform: uppercase;\n color: #4D6577;\n margin-bottom: 14px;\n display: block;\n}\n.co-wrap h1 {\n font-size: 32px;\n font-weight: 500;\n color: #323C52;\n margin: 0 0 22px;\n line-height: 1.2;\n letter-spacing: 0.5px;\n}\n.co-intro {\n font-size: 16px;\n font-weight: 400;\n line-height: 1.75;\n color: #4D6577;\n margin-bottom: 36px;\n padding-bottom: 32px;\n border-bottom: 1px solid rgba(77,101,119,.2);\n}\n.co-wrap h2 {\n font-size: 20px;\n font-weight: 600;\n color: #323C52;\n margin: 32px 0 12px;\n letter-spacing: 0.3px;\n}\n.co-wrap p {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.7;\n margin-bottom: 14px;\n}\n.co-list {\n list-style: none;\n padding: 0;\n margin: 12px 0 24px;\n}\n.co-list li {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n padding: 10px 14px 10px 38px;\n margin-bottom: 8px;\n border-radius: 6px;\n position: relative;\n background: rgba(77,101,119,.06);\n border-left: 3px solid #4D6577;\n}\n.co-list li::before {\n content: \"\u2713\";\n position: absolute;\n left: 12px;\n font-weight: 700;\n color: #4D6577;\n}\n.co-table {\n width: 100%;\n border-collapse: collapse;\n margin: 14px 0 22px;\n font-size: 14px;\n border-radius: 8px;\n overflow: hidden;\n}\n.co-table thead tr {\n background: #323C52;\n color: #fff;\n}\n.co-table thead th {\n padding: 11px 16px;\n text-align: left;\n font-weight: 600;\n font-size: 13px;\n}\n.co-table tbody tr:nth-child(even) {\n background: rgba(77,101,119,.06);\n}\n.co-table tbody tr:nth-child(odd) {\n background: #fff;\n}\n.co-table td {\n padding: 10px 16px;\n color: #4D6577;\n border-bottom: 1px solid rgba(77,101,119,.12);\n font-size: 14px;\n vertical-align: top;\n}\n.co-table td:first-child {\n font-weight: 600;\n color: #323C52;\n}\n.co-infobox {\n display: flex;\n gap: 12px;\n background: rgba(77,101,119,.06);\n border-radius: 8px;\n border-left: 4px solid #4D6577;\n padding: 14px 18px;\n margin: 18px 0 28px;\n font-size: 14px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.65;\n}\n.co-infobox .ico {\n font-size: 18px;\n flex-shrink: 0;\n}\n.co-urgence {\n background: #fff8f8;\n border-left: 5px solid #c0392b;\n border-radius: 6px;\n padding: 20px 26px;\n margin: 24px 0 32px;\n}\n.co-urgence .co-urgence-titre {\n font-size: 13px;\n font-weight: 700;\n color: #c0392b;\n letter-spacing: 1.5px;\n text-transform: uppercase;\n margin-bottom: 10px;\n}\n.co-urgence p {\n color: #5a2020;\n font-size: 14px;\n margin: 0 0 10px;\n line-height: 1.7;\n}\n.co-urgence p:last-child {\n margin-bottom: 0;\n}\n.co-disclaimer {\n font-size: 13px;\n color: #8a9aaa;\n font-style: italic;\n border-top: 1px solid rgba(77,101,119,.15);\n padding-top: 24px;\n margin-top: 40px;\n line-height: 1.6;\n}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n\n <span class=\"co-label\">Endocrinology & Preventive Cardiology & Family Medicine<\/span>\n <h1>Metabolic syndrome<\/h1>\n\n <div class=\"co-intro\">\n Metabolic syndrome (MS) - also known as syndrome X + insulin resistance syndrome + or dysmetabolic syndrome - is a grouping of metabolic and cardiovascular risk factors (abdominal obesity + arterial hypertension + atherogenic dyslipidemia + fasting hyperglycemia) which frequently co-exist in the same individual and which, when present simultaneously, synergistically multiply the risk of atherosclerotic cardiovascular disease (\u00d7 2 to 3 compared with the general population) + type 2 diabetes (\u00d7 5 to 7) + non-alcoholic fatty liver disease (NAFLD - affecting 70-90 % of people with DM) + and other conditions (polycystic ovary syndrome + sleep apnea + certain cancers + cognitive disorders). Insulin resistance - defined as reduced sensitivity of target tissues (skeletal muscle + liver + adipose tissue) to the metabolic actions of insulin + resulting in compensatory hyperinsulinemia to maintain normoglycemia - is considered the central pathophysiological abnormality of DM, although causality is bidirectional: excess visceral adipose tissue (metabolically active visceral adipocytes) produces pro-inflammatory adipokines + free fatty acids + and cytokines (TNF-\u03b1 + IL-6 + resistin) that aggravate insulin resistance + vascular inflammation + and atherosclerosis. The prevalence of DM varies from 20 to 35 % depending on the criteria used and the population studied in Canada - with an increasing trend parallel to the epidemic of obesity and sedentariness - and reaches 60-70 % in people with type 2 diabetes or severe obesity. The clinical importance of DM lies less in the diagnostic value of the \u00absyndrome\u00bb itself (which is sometimes disputed as a distinct diagnostic entity) than in the need to identify and aggressively treat each of its components to reduce overall cardiovascular risk.\n <\/div>\n\n <h2>Diagnostic criteria - harmonized IDF\/AHA\/NHLBI definition (2009)<\/h2>\n <ul class=\"co-list\">\n <li><strong>Definition: 3 of the following 5 criteria:<\/strong><\/li>\n <li><strong>1 - Abdominal obesity (waist circumference) :<\/strong> man \u2265 102 cm + woman \u2265 88 cm (North American thresholds) + or man \u2265 94 cm + woman \u2265 80 cm (European thresholds + IDF - recommended for populations in South Asia + East Asia + Sub-Saharan Africa + Latin America) \u2192 waist circumference is measured at umbilicus + end of exhalation + standing patient<\/li>\n <li><strong>2 - High triglycerides :<\/strong> \u2265 1.7 mmol\/L (\u2265 150 mg\/dL) + or specific hypolipidemic treatment for this anomaly<\/li>\n <li><strong>3 - Low HDL cholesterol :<\/strong> male < 1.0 mmol\/L (< 40 mg\/dL) + female < 1.3 mmol\/L (< 50 mg\/dL) + or specific treatment for this anomaly<\/li>\n <li><strong>4 - High blood pressure :<\/strong> systolic \u2265 130 mmHg + or diastolic \u2265 85 mmHg + or antihypertensive treatment<\/li>\n <li><strong>5 - Elevated fasting blood glucose :<\/strong> \u2265 5.6 mmol\/L (\u2265 100 mg\/dL) + or antidiabetic treatment + or known type 2 diabetes<\/li>\n <\/ul>\n\n <h2>Pathophysiology - central vicious circle<\/h2>\n <ul class=\"co-list\">\n <li><strong>Visceral adipose tissue (TAV) :<\/strong> visceral (not subcutaneous) abdominal adiposity is the centerpiece of SM + visceral adipocytes are metabolically very active \u2192 massively release free fatty acids (FFA) to the portal vein \u2192 liver directly exposed to FFA \u2192 increased hepatic gluconeogenesis + steatosis + increased VLDL \u2192 hypertriglyceridemia + small dense LDL (atherogenic) + lowered HDL<\/li>\n <li><strong>Insulin resistance:<\/strong> FFAs + TAV cytokines (TNF-\u03b1 + IL-6) inhibit intracellular insulin signaling (IRS-1\/PI3K pathway) \u2192 resistant muscle + liver + adipose tissue \u2192 compensatory hyperinsulinemia \u2192 pancreas exerts increased secretion \u2192 \u03b2-cell exhaustion in the long term \u2192 type 2 diabetes<\/li>\n <li><strong>Chronic low-grade vascular inflammation :<\/strong> Slightly elevated CRP (1-3 mg\/L - high sensitivity) + fibrinogen + PAI-1 (plasminogen inhibitor) + prothrombotic state \u2192 accelerated atherosclerosis<\/li>\n <li><strong>RAAS activation:<\/strong> visceral adipose tissue produces angiotensinogen \u2192 hypertension + sodium reabsorption + aggravation of insulin resistance<\/li>\n <\/ul>\n\n <h2>Complications and associated risks<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Complication<\/th>\n <th>Approximate relative risk<\/th>\n <th>Main mechanism<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Type 2 diabetes<\/td>\n <td>\u00d7 5 \u00e0 7<\/td>\n <td>Progressive insulin resistance + \u03b2-cell exhaustion<\/td>\n <\/tr>\n <tr>\n <td>Cardiovascular diseases (heart attack + stroke)<\/td>\n <td>\u00d7 2 \u00e0 3<\/td>\n <td>Accelerated atherosclerosis + hypertension + atherogenic dyslipidemia + prothrombotic state<\/td>\n <\/tr>\n <tr>\n <td>MASLD \/ MASH (hepatic steatosis)<\/td>\n <td>70-90 % of SM have MASLD<\/td>\n <td>FFA influx to liver + hepatic insulin resistance \u2192 steatosis + MASH \u2192 fibrosis \u2192 cirrhosis<\/td>\n <\/tr>\n <tr>\n <td>PCOS<\/td>\n <td>Close association<\/td>\n <td>Hyperinsulinemia \u2192 ovarian androgen stimulation \u2192 anovulation<\/td>\n <\/tr>\n <tr>\n <td>Sleep apnea<\/td>\n <td>Bidirectional association<\/td>\n <td>Cervical obesity + insulin resistance aggravated by intermittent hypoxia<\/td>\n <\/tr>\n <tr>\n <td>Certain cancers<\/td>\n <td>Increased risk (colon + endometrium + breast + kidney + pancreas)<\/td>\n <td>Hyperinsulinemia + IGF-1 + estrogen (adipose tissue) + inflammation<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <h2>Treatment - lifestyle approach<\/h2>\n <ul class=\"co-list\">\n <li><strong>Weight loss (central treatment) :<\/strong> 5-10 % reduction in body weight \u2192 improvement in all SM components + reduced insulin resistance + decreased TG + increased HDL + lowered BP + normalized blood glucose + low-calorie diet (500-1,000 kcal\/day deficit) + Mediterranean or DASH diet + nutritional follow-up + weight goal: long-term maintenance takes priority over rapid initial loss<\/li>\n <li><strong>Physical activity :<\/strong> 150-300 min\/week of moderate-intensity aerobic activity (brisk walking + cycling + swimming) + muscular resistance 2-3 \u00d7\/week \u2192 reduction in insulin resistance + lipid improvement + reduction in BP + independently of weight loss (physical activity improves insulin sensitivity even without weight loss)<\/li>\n <li><strong>Treatment of hypertension :<\/strong> if BP \u2265 130\/80 mmHg + ACE inhibitor or ARB II = first choice (renal protection + hepatoprotection + reduced insulin resistance) + or calcino antagonists + avoid beta-blockers in 1st line (worsening of insulin resistance + dyslipidemia)<\/li>\n <li><strong>Treatment of dyslipidemia :<\/strong> statins if high cardiovascular risk (LDL-C \u2265 3.4 mmol\/L or Framingham risk \u2265 15 %) \u2192 atorvastatin + rosuvastatin + fibrates if very high TG (> 5.6 mmol\/L - risk of pancreatitis) + or high-dose omega-3 (Vascepa\u00ae - ethyl icosapentaenoate - if TG 1.5-5.6 mmol\/L with high CV risk)<\/li>\n <li><strong>Treatment of hyperglycemia :<\/strong> if prediabetes \u2192 metformin (especially if BMI \u2265 35 + or history of gestational diabetes) + if type 2 diabetes \u2192 metformin in 1st line + SGLT2 (empagliflozin + dapagliflozin) and\/or GLP-1 (semaglutide + liraglutide) = 2nd line + additional beneficial effects on weight + BP + TG + liver (MASLD) + cardiovascular and renal protection<\/li>\n <li><strong>GLP-1 and double\/triple agonists (cross-sectional treatment of DM) :<\/strong> s\u00e9maglutide (Ozempic\u00ae + Wegovy\u00ae) + tirzepatide (Mounjaro\u00ae) \u2192 weight loss 15-22 % of body weight + reduction of all SM components + reduction of MASLD + major cardiovascular protection (SELECT + SURMOUNT-MMO) \u2192 SM transforming agents in 2024<\/li>\n <li><strong>Bariatric surgery:<\/strong> if BMI \u2265 35 with comorbidities (DM + diabetes + hypertension + apnea) + or BMI \u2265 40 \u2192 resolution of DM in 80-90 % + remission of type 2 diabetes in 50-80 % + reduction in cardiovascular mortality demonstrated<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>Waist circumference is the most important and under-used clinical measure in the assessment of a patient with metabolic syndrome - it is more predictive of cardiovascular and metabolic risk than BMI alone, as it reflects visceral (metabolically active) adiposity rather than total adiposity. A man with a normal BMI but a waist circumference of 100 cm has a significantly increased cardiovascular and metabolic risk. Measuring waist circumference at each annual check-up is as important as measuring blood pressure.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Medical consultation recommended<\/div>\n <p>Consult a physician for a complete metabolic work-up if you have excess abdominal weight + high blood pressure + chronic fatigue + or a family history of diabetes or early cardiovascular disease. Metabolic syndrome is silent and asymptomatic - it is most often discovered during a routine blood test. Early management with lifestyle modifications + metformin + and newer agents (GLP-1 + SGLT2) can prevent type 2 diabetes and significantly reduce cardiovascular risk. For metabolic syndrome assessment (blood glucose + lipids + waist circumference + BP) and treatment initiation, Clinique Omicron offers consultations at its points of service in Quebec and via telemedicine. To book an appointment, visit <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Clinique Omicron's specialized physicians and nurse practitioners (IPS) screen for metabolic syndrome using waist circumference + fasting blood glucose + lipid profile + blood pressure, calculate overall cardiovascular risk (Framingham + SCORE), initiate lifestyle modifications + metformin if prediabetes + statins if high CV risk + SGLT2 or GLP-1 if type 2 diabetes + appropriate antihypertensives (IEC\/ARA II), refer to nutrition + kinesiology + bariatric surgery according to patient profile, and ensure annual follow-up of SM components. Consultations are available at several points of service in Quebec and via telemedicine. To book an appointment, visit <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">The contents of this page are provided for information purposes only and do not replace medical advice. Metabolic syndrome is a high cardiovascular and metabolic risk factor requiring integrated global management - lifestyle modifications as a priority, followed by targeted pharmacological treatment for each component if objectives are not met. Waist circumference should be measured at each annual consultation.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Syndrome m\u00e9tabolique : crit\u00e8res diagnostiques, risque cardiovasculaire et traitement | Clinique Omicron Endocrinologie & Cardiologie pr\u00e9ventive & M\u00e9decine de famille Syndrome m\u00e9tabolique Le syndrome m\u00e9tabolique (SM) \u2014 \u00e9galement d\u00e9sign\u00e9 syndrome X + syndrome de r\u00e9sistance \u00e0 l’insuline + ou syndrome dysm\u00e9tabolique \u2014 est un regroupement de facteurs de risque m\u00e9taboliques et cardiovasculaires (ob\u00e9sit\u00e9 abdominale +… <a href=\"https:\/\/cliniqueomicron.ca\/en\/syndrome-metabolique\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Metabolic syndrome: diagnostic criteria, cardiovascular risk and treatment | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Syndrome m\u00e9tabolique | Brossard | Clinique Omicron","_metasync_otto_description":"Syndrome m\u00e9tabolique Syndrome m\u00e9tabolique est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnels de...","_metasync_otto_keywords":"","_metasync_otto_og_title":"Syndrome Metabolique | Clinique Omicron Qu\u00e9bec","_metasync_otto_og_description":"Syndrome m\u00e9tabolique Syndrome m\u00e9tabolique est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnels de...","_metasync_otto_twitter_title":"Syndrome Metabolique | Clinique Omicron","_metasync_otto_twitter_description":"Syndrome m\u00e9tabolique Syndrome m\u00e9tabolique est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnels de...","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"Syndrome m\u00e9tabolique : crit\u00e8res diagnostiques, risque cardiovasculaire et traitement | Clinique Omicron","_aioseo_description":"Le syndrome m\u00e9tabolique regroupe ob\u00e9sit\u00e9 abdominale HTA dyslipid\u00e9mie et hyperglyc\u00e9mie. Crit\u00e8res IDF 3\/5 tour de taille \u2265102cm homme, r\u00e9sistance insuline MASLD risque CV x2-3 diab\u00e8te x5-7, GLP-1 SGLT2 statines mode de vie au Qu\u00e9bec.","_metasync_seo_title":"","_metasync_seo_desc":"","_metasync_breadcrumb_title":"","_metasync_primary_category":0,"_metasync_primary_product_cat":0,"_metasync_otto_disabled":"","_metasync_hreflang":"","_metasync_plugin_sync_ts":"{\"aioseo\":\"2026-05-04T21:52:31+00:00\"}","_metasync_robots_advanced":"","footnotes":""},"class_list":["post-24985","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24985","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/comments?post=24985"}],"version-history":[{"count":4,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24985\/revisions"}],"predecessor-version":[{"id":31783,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24985\/revisions\/31783"}],"wp:attachment":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/media?parent=24985"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

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\n\t\t\t\t\t\n\n\n\n\nMetabolic syndrome: diagnostic criteria, cardiovascular risk and treatment | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"The metabolic syndrome combines abdominal obesity, hypertension, dyslipidemia and hyperglycemia, amplifying the risk of cardiovascular disease and diabetes. IDF criteria, waist circumference, statins and management in Quebec.\">\n<meta name=\"keywords\" content=\"syndrome m\u00e9tabolique, syndrome m\u00e9tabolique crit\u00e8res, syndrome m\u00e9tabolique traitement, tour de taille syndrome m\u00e9tabolique, r\u00e9sistance insuline syndrome m\u00e9tabolique, syndrome m\u00e9tabolique diab\u00e8te, syndrome m\u00e9tabolique cardiovasculaire, ob\u00e9sit\u00e9 abdominale, syndrome m\u00e9tabolique IDF, syndrome m\u00e9tabolique Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n@import url('https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap');\n\n.co-wrap * {\n font-family: 'Poppins', sans-serif;\n box-sizing: border-box;\n}\n.co-wrap {\n max-width: 1100px;\n margin: 0 auto;\n padding: 30px 0 60px;\n margin-top: 10px;\n}\n.co-label {\n font-family: 'Cinzel', serif;\n font-size: 14px;\n font-weight: bold;\n letter-spacing: 1px;\n text-transform: uppercase;\n color: #4D6577;\n margin-bottom: 14px;\n display: block;\n}\n.co-wrap h1 {\n font-size: 32px;\n font-weight: 500;\n color: #323C52;\n margin: 0 0 22px;\n line-height: 1.2;\n letter-spacing: 0.5px;\n}\n.co-intro {\n font-size: 16px;\n font-weight: 400;\n line-height: 1.75;\n color: #4D6577;\n margin-bottom: 36px;\n padding-bottom: 32px;\n border-bottom: 1px solid rgba(77,101,119,.2);\n}\n.co-wrap h2 {\n font-size: 20px;\n font-weight: 600;\n color: #323C52;\n margin: 32px 0 12px;\n letter-spacing: 0.3px;\n}\n.co-wrap p {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.7;\n margin-bottom: 14px;\n}\n.co-list {\n list-style: none;\n padding: 0;\n margin: 12px 0 24px;\n}\n.co-list li {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n padding: 10px 14px 10px 38px;\n margin-bottom: 8px;\n border-radius: 6px;\n position: relative;\n background: rgba(77,101,119,.06);\n border-left: 3px solid #4D6577;\n}\n.co-list li::before {\n content: \"\u2713\";\n position: absolute;\n left: 12px;\n font-weight: 700;\n color: #4D6577;\n}\n.co-table {\n width: 100%;\n border-collapse: collapse;\n margin: 14px 0 22px;\n font-size: 14px;\n border-radius: 8px;\n overflow: hidden;\n}\n.co-table thead tr {\n background: #323C52;\n color: #fff;\n}\n.co-table thead th {\n padding: 11px 16px;\n text-align: left;\n font-weight: 600;\n font-size: 13px;\n}\n.co-table tbody tr:nth-child(even) {\n background: rgba(77,101,119,.06);\n}\n.co-table tbody tr:nth-child(odd) {\n background: #fff;\n}\n.co-table td {\n padding: 10px 16px;\n color: #4D6577;\n border-bottom: 1px solid rgba(77,101,119,.12);\n font-size: 14px;\n vertical-align: top;\n}\n.co-table td:first-child {\n font-weight: 600;\n color: #323C52;\n}\n.co-infobox {\n display: flex;\n gap: 12px;\n background: rgba(77,101,119,.06);\n border-radius: 8px;\n border-left: 4px solid #4D6577;\n padding: 14px 18px;\n margin: 18px 0 28px;\n font-size: 14px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.65;\n}\n.co-infobox .ico {\n font-size: 18px;\n flex-shrink: 0;\n}\n.co-urgence {\n background: #fff8f8;\n border-left: 5px solid #c0392b;\n border-radius: 6px;\n padding: 20px 26px;\n margin: 24px 0 32px;\n}\n.co-urgence .co-urgence-titre {\n font-size: 13px;\n font-weight: 700;\n color: #c0392b;\n letter-spacing: 1.5px;\n text-transform: uppercase;\n margin-bottom: 10px;\n}\n.co-urgence p {\n color: #5a2020;\n font-size: 14px;\n margin: 0 0 10px;\n line-height: 1.7;\n}\n.co-urgence p:last-child {\n margin-bottom: 0;\n}\n.co-disclaimer {\n font-size: 13px;\n color: #8a9aaa;\n font-style: italic;\n border-top: 1px solid rgba(77,101,119,.15);\n padding-top: 24px;\n margin-top: 40px;\n line-height: 1.6;\n}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n\n <span class=\"co-label\">Endocrinology & Preventive Cardiology & Family Medicine<\/span>\n <h1>Metabolic syndrome<\/h1>\n\n <div class=\"co-intro\">\n Metabolic syndrome (MS) - also known as syndrome X + insulin resistance syndrome + or dysmetabolic syndrome - is a grouping of metabolic and cardiovascular risk factors (abdominal obesity + arterial hypertension + atherogenic dyslipidemia + fasting hyperglycemia) which frequently co-exist in the same individual and which, when present simultaneously, synergistically multiply the risk of atherosclerotic cardiovascular disease (\u00d7 2 to 3 compared with the general population) + type 2 diabetes (\u00d7 5 to 7) + non-alcoholic fatty liver disease (NAFLD - affecting 70-90 % of people with DM) + and other conditions (polycystic ovary syndrome + sleep apnea + certain cancers + cognitive disorders). Insulin resistance - defined as reduced sensitivity of target tissues (skeletal muscle + liver + adipose tissue) to the metabolic actions of insulin + resulting in compensatory hyperinsulinemia to maintain normoglycemia - is considered the central pathophysiological abnormality of DM, although causality is bidirectional: excess visceral adipose tissue (metabolically active visceral adipocytes) produces pro-inflammatory adipokines + free fatty acids + and cytokines (TNF-\u03b1 + IL-6 + resistin) that aggravate insulin resistance + vascular inflammation + and atherosclerosis. The prevalence of DM varies from 20 to 35 % depending on the criteria used and the population studied in Canada - with an increasing trend parallel to the epidemic of obesity and sedentariness - and reaches 60-70 % in people with type 2 diabetes or severe obesity. The clinical importance of DM lies less in the diagnostic value of the \u00absyndrome\u00bb itself (which is sometimes disputed as a distinct diagnostic entity) than in the need to identify and aggressively treat each of its components to reduce overall cardiovascular risk.\n <\/div>\n\n <h2>Diagnostic criteria - harmonized IDF\/AHA\/NHLBI definition (2009)<\/h2>\n <ul class=\"co-list\">\n <li><strong>Definition: 3 of the following 5 criteria:<\/strong><\/li>\n <li><strong>1 - Abdominal obesity (waist circumference) :<\/strong> man \u2265 102 cm + woman \u2265 88 cm (North American thresholds) + or man \u2265 94 cm + woman \u2265 80 cm (European thresholds + IDF - recommended for populations in South Asia + East Asia + Sub-Saharan Africa + Latin America) \u2192 waist circumference is measured at umbilicus + end of exhalation + standing patient<\/li>\n <li><strong>2 - High triglycerides :<\/strong> \u2265 1.7 mmol\/L (\u2265 150 mg\/dL) + or specific hypolipidemic treatment for this anomaly<\/li>\n <li><strong>3 - Low HDL cholesterol :<\/strong> male < 1.0 mmol\/L (< 40 mg\/dL) + female < 1.3 mmol\/L (< 50 mg\/dL) + or specific treatment for this anomaly<\/li>\n <li><strong>4 - High blood pressure :<\/strong> systolic \u2265 130 mmHg + or diastolic \u2265 85 mmHg + or antihypertensive treatment<\/li>\n <li><strong>5 - Elevated fasting blood glucose :<\/strong> \u2265 5.6 mmol\/L (\u2265 100 mg\/dL) + or antidiabetic treatment + or known type 2 diabetes<\/li>\n <\/ul>\n\n <h2>Pathophysiology - central vicious circle<\/h2>\n <ul class=\"co-list\">\n <li><strong>Visceral adipose tissue (TAV) :<\/strong> visceral (not subcutaneous) abdominal adiposity is the centerpiece of SM + visceral adipocytes are metabolically very active \u2192 massively release free fatty acids (FFA) to the portal vein \u2192 liver directly exposed to FFA \u2192 increased hepatic gluconeogenesis + steatosis + increased VLDL \u2192 hypertriglyceridemia + small dense LDL (atherogenic) + lowered HDL<\/li>\n <li><strong>Insulin resistance:<\/strong> FFAs + TAV cytokines (TNF-\u03b1 + IL-6) inhibit intracellular insulin signaling (IRS-1\/PI3K pathway) \u2192 resistant muscle + liver + adipose tissue \u2192 compensatory hyperinsulinemia \u2192 pancreas exerts increased secretion \u2192 \u03b2-cell exhaustion in the long term \u2192 type 2 diabetes<\/li>\n <li><strong>Chronic low-grade vascular inflammation :<\/strong> Slightly elevated CRP (1-3 mg\/L - high sensitivity) + fibrinogen + PAI-1 (plasminogen inhibitor) + prothrombotic state \u2192 accelerated atherosclerosis<\/li>\n <li><strong>RAAS activation:<\/strong> visceral adipose tissue produces angiotensinogen \u2192 hypertension + sodium reabsorption + aggravation of insulin resistance<\/li>\n <\/ul>\n\n <h2>Complications and associated risks<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Complication<\/th>\n <th>Approximate relative risk<\/th>\n <th>Main mechanism<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Type 2 diabetes<\/td>\n <td>\u00d7 5 \u00e0 7<\/td>\n <td>Progressive insulin resistance + \u03b2-cell exhaustion<\/td>\n <\/tr>\n <tr>\n <td>Cardiovascular diseases (heart attack + stroke)<\/td>\n <td>\u00d7 2 \u00e0 3<\/td>\n <td>Accelerated atherosclerosis + hypertension + atherogenic dyslipidemia + prothrombotic state<\/td>\n <\/tr>\n <tr>\n <td>MASLD \/ MASH (hepatic steatosis)<\/td>\n <td>70-90 % of SM have MASLD<\/td>\n <td>FFA influx to liver + hepatic insulin resistance \u2192 steatosis + MASH \u2192 fibrosis \u2192 cirrhosis<\/td>\n <\/tr>\n <tr>\n <td>PCOS<\/td>\n <td>Close association<\/td>\n <td>Hyperinsulinemia \u2192 ovarian androgen stimulation \u2192 anovulation<\/td>\n <\/tr>\n <tr>\n <td>Sleep apnea<\/td>\n <td>Bidirectional association<\/td>\n <td>Cervical obesity + insulin resistance aggravated by intermittent hypoxia<\/td>\n <\/tr>\n <tr>\n <td>Certain cancers<\/td>\n <td>Increased risk (colon + endometrium + breast + kidney + pancreas)<\/td>\n <td>Hyperinsulinemia + IGF-1 + estrogen (adipose tissue) + inflammation<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <h2>Treatment - lifestyle approach<\/h2>\n <ul class=\"co-list\">\n <li><strong>Weight loss (central treatment) :<\/strong> 5-10 % reduction in body weight \u2192 improvement in all SM components + reduced insulin resistance + decreased TG + increased HDL + lowered BP + normalized blood glucose + low-calorie diet (500-1,000 kcal\/day deficit) + Mediterranean or DASH diet + nutritional follow-up + weight goal: long-term maintenance takes priority over rapid initial loss<\/li>\n <li><strong>Physical activity :<\/strong> 150-300 min\/week of moderate-intensity aerobic activity (brisk walking + cycling + swimming) + muscular resistance 2-3 \u00d7\/week \u2192 reduction in insulin resistance + lipid improvement + reduction in BP + independently of weight loss (physical activity improves insulin sensitivity even without weight loss)<\/li>\n <li><strong>Treatment of hypertension :<\/strong> if BP \u2265 130\/80 mmHg + ACE inhibitor or ARB II = first choice (renal protection + hepatoprotection + reduced insulin resistance) + or calcino antagonists + avoid beta-blockers in 1st line (worsening of insulin resistance + dyslipidemia)<\/li>\n <li><strong>Treatment of dyslipidemia :<\/strong> statins if high cardiovascular risk (LDL-C \u2265 3.4 mmol\/L or Framingham risk \u2265 15 %) \u2192 atorvastatin + rosuvastatin + fibrates if very high TG (> 5.6 mmol\/L - risk of pancreatitis) + or high-dose omega-3 (Vascepa\u00ae - ethyl icosapentaenoate - if TG 1.5-5.6 mmol\/L with high CV risk)<\/li>\n <li><strong>Treatment of hyperglycemia :<\/strong> if prediabetes \u2192 metformin (especially if BMI \u2265 35 + or history of gestational diabetes) + if type 2 diabetes \u2192 metformin in 1st line + SGLT2 (empagliflozin + dapagliflozin) and\/or GLP-1 (semaglutide + liraglutide) = 2nd line + additional beneficial effects on weight + BP + TG + liver (MASLD) + cardiovascular and renal protection<\/li>\n <li><strong>GLP-1 and double\/triple agonists (cross-sectional treatment of DM) :<\/strong> s\u00e9maglutide (Ozempic\u00ae + Wegovy\u00ae) + tirzepatide (Mounjaro\u00ae) \u2192 weight loss 15-22 % of body weight + reduction of all SM components + reduction of MASLD + major cardiovascular protection (SELECT + SURMOUNT-MMO) \u2192 SM transforming agents in 2024<\/li>\n <li><strong>Bariatric surgery:<\/strong> if BMI \u2265 35 with comorbidities (DM + diabetes + hypertension + apnea) + or BMI \u2265 40 \u2192 resolution of DM in 80-90 % + remission of type 2 diabetes in 50-80 % + reduction in cardiovascular mortality demonstrated<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>Waist circumference is the most important and under-used clinical measure in the assessment of a patient with metabolic syndrome - it is more predictive of cardiovascular and metabolic risk than BMI alone, as it reflects visceral (metabolically active) adiposity rather than total adiposity. A man with a normal BMI but a waist circumference of 100 cm has a significantly increased cardiovascular and metabolic risk. Measuring waist circumference at each annual check-up is as important as measuring blood pressure.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Medical consultation recommended<\/div>\n <p>Consult a physician for a complete metabolic work-up if you have excess abdominal weight + high blood pressure + chronic fatigue + or a family history of diabetes or early cardiovascular disease. Metabolic syndrome is silent and asymptomatic - it is most often discovered during a routine blood test. Early management with lifestyle modifications + metformin + and newer agents (GLP-1 + SGLT2) can prevent type 2 diabetes and significantly reduce cardiovascular risk. For metabolic syndrome assessment (blood glucose + lipids + waist circumference + BP) and treatment initiation, Clinique Omicron offers consultations at its points of service in Quebec and via telemedicine. To book an appointment, visit <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Clinique Omicron's specialized physicians and nurse practitioners (IPS) screen for metabolic syndrome using waist circumference + fasting blood glucose + lipid profile + blood pressure, calculate overall cardiovascular risk (Framingham + SCORE), initiate lifestyle modifications + metformin if prediabetes + statins if high CV risk + SGLT2 or GLP-1 if type 2 diabetes + appropriate antihypertensives (IEC\/ARA II), refer to nutrition + kinesiology + bariatric surgery according to patient profile, and ensure annual follow-up of SM components. Consultations are available at several points of service in Quebec and via telemedicine. To book an appointment, visit <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">The contents of this page are provided for information purposes only and do not replace medical advice. Metabolic syndrome is a high cardiovascular and metabolic risk factor requiring integrated global management - lifestyle modifications as a priority, followed by targeted pharmacological treatment for each component if objectives are not met. Waist circumference should be measured at each annual consultation.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Syndrome m\u00e9tabolique : crit\u00e8res diagnostiques, risque cardiovasculaire et traitement | Clinique Omicron Endocrinologie & Cardiologie pr\u00e9ventive & M\u00e9decine de famille Syndrome m\u00e9tabolique Le syndrome m\u00e9tabolique (SM) \u2014 \u00e9galement d\u00e9sign\u00e9 syndrome X + syndrome de r\u00e9sistance \u00e0 l’insuline + ou syndrome dysm\u00e9tabolique \u2014 est un regroupement de facteurs de risque m\u00e9taboliques et cardiovasculaires (ob\u00e9sit\u00e9 abdominale +… <a href=\"https:\/\/cliniqueomicron.ca\/en\/syndrome-metabolique\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Metabolic syndrome: diagnostic criteria, cardiovascular risk and treatment | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Syndrome m\u00e9tabolique | Brossard | Clinique Omicron","_metasync_otto_description":"Syndrome m\u00e9tabolique Syndrome m\u00e9tabolique est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnels de...","_metasync_otto_keywords":"","_metasync_otto_og_title":"Syndrome Metabolique | Clinique Omicron Qu\u00e9bec","_metasync_otto_og_description":"Syndrome m\u00e9tabolique Syndrome m\u00e9tabolique est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnels de...","_metasync_otto_twitter_title":"Syndrome Metabolique | Clinique Omicron","_metasync_otto_twitter_description":"Syndrome m\u00e9tabolique Syndrome m\u00e9tabolique est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnels de...","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"Syndrome m\u00e9tabolique : crit\u00e8res diagnostiques, risque cardiovasculaire et traitement | Clinique Omicron","_aioseo_description":"Le syndrome m\u00e9tabolique regroupe ob\u00e9sit\u00e9 abdominale HTA dyslipid\u00e9mie et hyperglyc\u00e9mie. 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