Metabolic Syndrome: Diagnostic Criteria, Staging, and Prevention Strategies in Chinese Patients

Metabolic syndrome is a condition characterized by the accumulation of multiple diseases such as hypertension, hyperglycemia, hyperlipidemia, and obesity. Its prominent manifestations include overweight, obesity, hypertension, and arteriosclerosis. A common pathogenesis is insulin resistance. Currently, the prevalence of metabolic syndrome in people over 20 years of age is 10%–14%. In 2004, the Chinese Diabetes Society proposed diagnostic criteria suitable for the Chinese population.

Table 10 Diagnostic Criteria for Metabolic Syndrome | Item | Criteria | | :--- | :--- | | Obesity | BMI ≥ 25 | | Hypertension | SBP ≥ 140 mmHg, DBP ≥ 90 mmHg, or already diagnosed and receiving treatment | | Hyperlipidemia | TG ≥ 150 mg/dl, HDL-C < 35 mg/dl for men, HDL-C < 39 mg/dl for women | | Hyperglycemia | FPG ≥ 110 mg/dl, 2h PG ≥ 140 mg/dl, or already diagnosed and receiving treatment | | Diagnosis | A diagnosis can be made if 3 or all 4 of the above criteria are met.

Currently, there is a tendency to include hyperuricemia in this category, forming the "six highs and one lipid": high weight (obesity), high blood pressure, high blood lipids, hyperuricemia, hyperinsulinemia, hyperglycemia, and fatty liver. Central obesity is a risk factor for metabolic syndrome. Waist-to-hip ratio (WHR) = waist circumference/hip circumference. Central obesity criteria: men >0.9, women >0.85. Prevention staging strategies: ① Early stage: Focus on prevention: Control various risk factors. The primary treatment is to adjust lifestyle habits, lose weight, and exercise. The main goals are to lower LDL-C, blood sugar, and blood pressure. ② Mid-stage: Focus on treatment: Often, related organ damage has occurred. Ventricular thickening, abnormal kidney function. Medications required include antihypertensive drugs, lipid-lowering drugs, and insulin sensitizers. Reversal is possible. ③ Late stage: Focus on rescue: Organ dysfunction or irreversible damage has occurred (such as stroke, myocardial infarction, heart and kidney failure). The main focus is on symptomatic treatment to save lives as much as possible. BMI (Body Mass Index) is used to determine whether a person's weight is appropriate: BMI = actual weight (kg) ÷ height squared (m²). A BMI between 18.5 and 23.9 is considered an appropriate weight. Overweight and obesity are independent risk factors for coronary heart disease and stroke.