Development and causes

Five individual causes in interplay

Metabolic syndrome is determined by various metabolic disorders. Both genetic predisposition and excess weight play a major part in its development. The underlying cause is always a heavy deposit of fat in the abdominal cavity, accompanied by at least two of four risk factors: reduced HDL cholesterol, arterial high blood pressure, and raised blood fat or blood sugar levels. How these five individual causes burden the body and, in interplay, reinforce one another ever further is explained in the following sections.

Belly fat – the visible hallmark

Excess weight is generally a risk factor for health, but abdominal obesity, that is, abdominal excess weight, carries a particular risk. It is characterised by increased fat deposits in the abdominal cavity. This is because fat cells in the abdominal cavity react differently from the cells of the subcutaneous fat on the thighs, arms or buttocks: they release considerably more triglycerides, are more insulin-resistant and produce more inflammatory substances.

In the early stage, belly fat is not yet recognisable. When it becomes visible, it can be a serious warning sign of metabolic syndrome: because of the increased release of triglycerides into the blood, people with abdominal excess weight often have a raised blood fat level and further metabolic disorders of metabolic syndrome.

Raised blood fat level

An imbalance between energy intake and energy expenditure increases the concentration of fatty acids in the blood. From 150 milligrams of triglycerides per decilitre, doctors speak of hypertriglyceridaemia, a raised blood fat level. Triglycerides thicken the blood and gradually deposit on the walls of the blood vessels. If hypertriglyceridaemia remains untreated, the vessel walls gradually calcify, which leads to arterial high blood pressure.

A raised blood fat level also disrupts glucose utilisation in muscle and fatty tissue and thus worsens blood sugar levels. Particularly unfavourable: increased triglycerides in the blood block fat breakdown in the cells and thus make weight loss more difficult.

Reduced HDL cholesterol

Cholesterol is often regarded as an enemy of health. That is certainly true of LDL cholesterol, but there is also “good cholesterol”: HDL cholesterol transports fat-like substances such as cholesterol esters and triglycerides and is an indispensable component of our body. Its main task is to transport excess fatty acids from the peripheral tissues, such as the walls of the blood vessels, back to the liver.

If the HDL cholesterol level is too low, the body can no longer fulfil this task. Blood fat levels rise, which lowers the concentration of HDL cholesterol further – the cycle of metabolic syndrome continues. Too much fat can also have a negative effect on sugar metabolism and cause high blood pressure.

Raised blood sugar level and insulin resistance

Anyone who eats too much risks developing diabetes, because over time the body can no longer cope with the oversupply of sugar. At first, it tries to move the sugar from the blood into the cells with increased insulin production. Through constant demand, the insulin receptors gradually become dulled. This insulin resistance is one reason why many people with excess weight suffer from diabetes.

Insulin resistance affects not only the blood sugar level, but also disrupts fat metabolism. For this reason, a pathologically raised blood sugar level is often accompanied by raised blood fat levels; the two reinforce each other. And just as too much fat in the blood increases the risk of high blood pressure, unhealthy blood sugar levels also increase the risk of arteriosclerosis.

Arterial high blood pressure

Arterial high blood pressure is a major contributing cause of metabolic syndrome. It can be hereditary and can therefore also affect slim people. Particularly often, however, the cause lies in an unhealthy lifestyle: smoking, alcohol, lack of exercise and, in particular, an overly plentiful diet can bring about arterial hypertension. Too much sugar, fat and nicotine in the blood deposit on the walls of the blood vessels; the vessels narrow more and more and blood pressure rises.