What are the risk factors for metabolic syndrome?

• Age. The prevalence of metabolic syndrome increases with age.
• Race. In Singapore, there is a higher proportion of metabolic syndrome among the Indians and Malays.
• Overweight/Obesity. A Body Mass Index (BMI) of 23 and above increases your risk of metabolic syndrome.
• Family history of diabetes. Women with high blood glucose during pregnancy also have greater risk of getting metabolic syndrome.
• Other medical conditions. People with high blood pressure, lipid disorders, or psoriasis have higher chance of developing metabolic syndrome

The more risk factors you have, the higher your risk of getting heart disease. If you have all of the risk factors, you are 6 times as likely to get heart disease.

If you adopt a sedentary lifestyle and become obese, you are also likely to have a higher risk.

What is the relationship between psoriasis and metabolic syndrome?

Patients with psoriasis have an increased risk for the metabolic syndrome. They are twice as likely to have the metabolic syndrome compared with healthy individuals.

The most common feature of the metabolic syndrome among psoriasis patients are : abdominal obesity, followed by high triglyceride levels and low levels of "good" high-density lipoprotein (HDL) cholesterol.

In patients with severe psoriasis, they have nearly 3 times increased risk of dying from heart disease.

Smoking and alcohol intake also increases the risk of heart disease.

Only about 10% of people with psoriasis had no features of metabolic syndrome.

Why is psoriasis related to metabolic syndrome?

In psoriasis, there is chronic inflammation of the skin and an imbalance in the skin's immune system.

Chronic inflammation can also contribute to heart disease, development of hypertension and diabetes.

Thus patients with psoriasis can be predisposed to heart disease and metabolic syndrome.

You have the metabolic syndrome if you have 3 or more of the following:

• waist circumference > 90 cm in men and 80 cm in women
• triglyceride level of 1.7 mmol/l or more
• high density lipoprotein (HDL) cholesterol of 1.0 mmol/l or less in men, and 1.3 mmol/l or less in women
• blood pressure of 130/85 mmHg or more, or on treatment for high blood pressure
• fasting glucose level of 6.1 mmol/l or more, or on treatment for diabetes

The only obvious sign is a large waistline with an "apple-shaped" body figure. Most of the conditions linked to metabolic syndrome may be silent.