Metabolic Syndrome: Signs, Diagnostics, and Modern Treatment Methods

What is Metabolic Syndrome?

Metabolic syndrome represents a combination of metabolic disorders that significantly increase the risk of developing type 2 diabetes mellitus, cardiovascular diseases, and other serious health problems. Although sources do not provide a single definition, they emphasize the importance of controlling metabolic processes to prevent the progression of various diseases, including neurodegenerative changes, as observed in Wolfram syndrome [1]. Key components of metabolic syndrome often include obesity (especially abdominal), insulin resistance, dyslipidemia (lipid metabolism disorder), and arterial hypertension.

Key Signs and Diagnostics

Recognizing metabolic syndrome begins with identifying its main signs:

• Obesity. Excess weight, especially in the abdomen, is one of the main factors. Obesity is a serious public health problem leading to diabetes, cardiovascular diseases, and certain types of cancer [3].
• Insulin Resistance and Diabetes. Impaired cellular sensitivity to insulin often precedes the development of type 2 diabetes mellitus. Non-autoimmune diabetes may be the first clinical sign of certain rare genetic disorders, such as Wolfram syndrome, which emphasizes the importance of early metabolic control [1].
• Dyslipidemia. Characterized by elevated levels of "bad" cholesterol (LDL), triglycerides, and reduced levels of "good" cholesterol (HDL). Studies show that certain compounds, such as methoxychalcones, can significantly reduce LDL, total cholesterol, and triglyceride levels while simultaneously increasing HDL [3].
• Arterial Hypertension. High blood pressure often accompanies other metabolic disorders.
• Inflammation. Metabolic syndrome is associated with chronic low-grade inflammation. Patients with immunometabolic depression exhibit inflammatory and metabolic disorders [2]. Some studies show a reduction in inflammatory markers, such as IL-1β, with effective obesity treatment [3].

Comprehensive Treatment Approach: The Foundation of Success

Given the multifactorial nature of metabolic syndrome, its treatment requires an interdisciplinary approach. This is particularly important for preventing the progression of comorbidities and neurodegenerative changes, as shown in the case of Wolfram syndrome [1].

Lifestyle Modification: The Cornerstone of Therapy

The basis of metabolic syndrome treatment is lifestyle modification, which includes diet, physical activity, and behavioral support.

• Diet. Structured nutritional programs, such as metabolic endolipolysis, have shown long-term positive results in combating obesity. These programs include strict fat restriction (about 30 g/day), adequate protein intake (≥110 g/day), and normoglycemic carbohydrate intake [5].
• Physical Activity. Physical exercise helps improve immunometabolic health and is recognized as an effective treatment for depression associated with metabolic disorders [2]. Increasing daily step count is one of the most common recommendations in lifestyle-based weight loss programs [6]. Studies show that such programs lead to increased physical activity and weight loss [6].
• Behavioral Support. An important component of successful long-term lifestyle modification programs, helping patients adhere to new habits [5].

Medical Treatment and New Perspectives

In cases where lifestyle changes are insufficient, or to enhance the effect, drug therapy may be prescribed.

• Existing Medications. Various pharmacotherapies are used to treat obesity in children and adolescents, including glucagon-like peptide-1 (GLP-1) receptor agonists, metformin, orlistat, and phentermine-topiramate [8].
• New Developments. New therapeutic agents are being investigated, such as methoxychalcones, which have shown potential in obesity management. In studies on rats with high-fat diet-induced obesity, these compounds significantly reduced body weight, insulin levels, LDL cholesterol, and triglycerides, and also improved liver and kidney function [3].

Surgical Methods: When Conservative Treatment is Insufficient

Metabolic and bariatric surgery (MBS) is an effective method for significant weight loss and the resolution of metabolic diseases. These surgeries can lead to remission of diabetes, hypertension, and sleep apnea in many patients, as well as increase life expectancy by 5-9 years [4].

Guidelines from the American Society for Metabolic and Bariatric Surgery recommend surgery for all patients with a body mass index (BMI) of 35 kg/m² and higher, as well as for patients with diabetes who have a BMI of 30 kg/m² and higher, regardless of previous non-surgical weight loss efforts [4]. For children older than 13 years, MBS is also recommended and does not have a negative impact on growth or development [4].

Features of Metabolic Syndrome in Children

Pediatric obesity is a global public health problem [8]. Although health-behavior lifestyle treatment (HBLT) is fundamental, the response to it in children with obesity can be variable and unpredictable [7, 8]. Systematic reviews compare the efficacy of HBLT, various pharmacotherapies (such as GLP-1 receptor agonists, metformin, orlistat, phentermine-topiramate), and their combinations for weight management in children and adolescents [8]. Studies are also aimed at finding molecular markers that could predict the outcomes of lifestyle modification in children [7].

Sources

1. [1] Metabolic Treatment of Wolfram Syndrome. (International Journal of Environmental Research and Public Health, 2022) https://pubmed.ncbi.nlm.nih.gov/35270448/
2. [2] Running therapy or antidepressants as treatments for immunometabolic depression in patients with depressive and anxiety disorders: A secondary analysis of the MOTAR study. (Brain, Behavior, and Immunity, 2025) https://pubmed.ncbi.nlm.nih.gov/39477079/
3. [3] Methoxychalcones: a promising therapeutic agent for obesity management. (Biochemical and Biophysical Research Communications, 2026) https://pubmed.ncbi.nlm.nih.gov/42105573/
4. [4] Obesity Management: Surgical Interventions. (American Family Physician, 2026) https://pubmed.ncbi.nlm.nih.gov/42101583/
5. [5] Long-term outcomes of a structured lifestyle-based nutritional intervention for obesity management: a 10-year observational study. (Eating and Weight Disorders, 2026) https://pubmed.ncbi.nlm.nih.gov/42113387/
6. [6] Daily Steps During Nutritional Lifestyle Modification Programs for Obesity Management: A Systematic Review and Meta-Analysis. (International Journal of Environmental Research and Public Health, 2026) https://pubmed.ncbi.nlm.nih.gov/42074460/
7. [7] Circulating mRNA and miRNA signatures used as predictive markers of lifestyle modification outcomes in pediatric obesity management. (Hormone Research in Paediatrics, 2026) https://pubmed.ncbi.nlm.nih.gov/42391183/
8. [8] Obesity Management Pharmacotherapies and Lifestyle Treatment for Pediatric Obesity Management: A Systematic Review and Network Meta-Analysis. (JAMA Pediatrics, 2026) https://pubmed.ncbi.nlm.nih.gov/42329656/

The information presented in this article is for reference purposes only and should not be used for self-diagnosis or self-treatment. Always consult a qualified medical professional for an accurate diagnosis and an individualized treatment plan.