Identification and Management of Metabolic Syndrome: The Role of the APN

Douglas H. Sutton, EdD, MSN; Deborah A. Raines, PhD


Topics in Advanced Practice Nursing eJournal. 2007;7(2) 

In This Article

Introduction to Metabolic Syndrome

Metabolic syndrome is a complex and evolving cluster of adverse risk factors that may end in the development of atherosclerotic cardiovascular disease (CVD) and type 2 diabetes mellitus (DM) and their associated morbidities.[2,4] Other names for metabolic syndrome include:

  • Insulin resistance syndrome;

  • Syndrome X; and

  • Dysmetabolic syndrome.

Reaven first described syndrome X as a cluster of diabetes, hypertension, and coronary artery disease with dyslipidemia in 1988.[5] It is believed that the major underlying metabolic abnormality is insulin resistance.[6] Because insulin resistance is closely associated with obesity, particularly with abdominal obesity, the recent escalation of obesity in the United States and other industrialized countries has been accompanied by a parallel increase in the prevalence of metabolic syndrome.[7,8,9]

Metabolic syndrome is a relatively common, yet potentially devastating, prognosticator for the development of atherosclerotic CVD. The Third Report of the National Cholesterol Education Program Expert Panel (NCEP) on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) found that ethnicity influences the prevalence of metabolic syndrome.[10] Mexican Americans now have the highest age-adjusted prevalence of metabolic syndrome for both men and women, and African-American women have a higher incidence of metabolic syndrome than African-American men.[10,11]

The etiology, pathophysiology, signs, symptoms, diagnostic tests, and treatment for metabolic syndrome are examined through a case study developed on the basis of several characteristics of an actual patient. Early recognition and intervention in patients with metabolic syndrome can have a positive impact on outcomes and decrease long-term morbidity.


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