What is the prognosis of metabolic syndrome?

Updated: Mar 30, 2020
  • Author: Stanley S Wang, JD, MD, MPH; Chief Editor: Yasmine S Ali, MD, MSCI, FACC, FACP  more...
  • Print

The complications of metabolic syndrome are broad. Numerous associated cardiovascular complications exist, particularly coronary heart disease, but also atrial fibrillation, [57, 58] heart failure, [59] aortic stenosis, [60] ischemic stroke, [61] and, possibly, venothromboembolic disease. [62]  Cardiovascular disease and diabetes mellitus coexist and are two leading causes of death. [10, 20]  Evidence also exists to indicate that upregulation of the renin-angiotensin-aldosterone system and derangements to metabolic pathways (eg, glucose and fat metabolism) can also promote pulmonary vascular disease (eg, pulmonary arterial hypertension) and right heart failure. [59]

Emerging data suggest an important correlation between metabolic syndrome and risk of stroke. [63] Each of the components of metabolic syndrome has been associated with elevated stroke risk, and evidence demonstrates a relationship between the collective metabolic syndrome and risk of ischemic stroke. [64] Metabolic syndrome may also be linked to neuropathy beyond hyperglycemic mechanisms through inflammatory mediators. [65]

The metabolic derangements that characterize metabolic syndrome have been implicated in the development of nonalcoholic fatty liver disease. [66, 67] Indeed, the fatty liver is thought to play an important role in the development of metabolic syndrome. [68]

In addition, metabolic syndrome has been implicated in the pathophysiology of several other diseases, including obstructive sleep apnea. Breast cancer has also been linked to metabolic syndrome, possibly through dysregulation of the plasminogen activator inhibitor-1 (PAI-1) cycle. [69] Additional studies have linked metabolic syndrome with cancers of the colon, gallbladder, kidney, and, possibly, prostate gland. [70] Evidence is emerging of an association with psoriasis. [71, 72]

Metabolic syndrome between pregnancies increases the risk of recurrent preeclampsia, according to a retrospective cohort study of 197 women who had preeclampsia during their first pregnancy. Of the 197 women, 40 (20%) had metabolic syndrome between pregnancies. Of these 40 women, 18 (45%) had preeclampsia during their second pregnancy, compared with 27 (17%) of the 157 women without metabolic syndrome between pregnancies. The risk of recurrent preeclampsia increased with the number of components of the metabolic syndrome present. [73, 74]

Additional research has raised the possibility that metabolic syndrome adversely affects neurocognitive performance. [75] In particular, metabolic syndrome has been blamed for accelerated cognitive aging. [76] Patients with mental illnesses also face increased cardiometabolic risk due at least in part to socioeconomic factors such as greater poverty and poorer access to medical care. [77, 78]

Paradoxically, metabolic syndrome was associated with a lower risk of bone fractures in a meta-analysis. [79] Further study is warranted.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!