# Metabolic Syndrome & Insulin Resistance
URL: https://genohealth.app/conditions/metabolic-syndrome
Type: Condition
Evidence: Strong evidence
Last reviewed: 2025-06-30

## Intro
Metabolic syndrome is defined by having three or more of: central obesity, elevated fasting glucose, low HDL, high triglycerides, or elevated blood pressure. It's largely reversible with diet, exercise and weight loss — particularly when caught early.

## Summary
A cluster of central adiposity, high blood pressure, dyslipidemia and high blood sugar that multiplies cardiovascular and type-2 diabetes risk.

## Key facts
- Top biomarkers: Fasting insulin, A1c, triglycerides/HDL ratio
- Key genes: TCF7L2, FTO, PPARG, MTNR1B
- Highest-leverage lever: 5-10% body weight loss

## Diagnostic criteria (ATP III)
- Waist circumference > 102 cm (men) or > 88 cm (women)
- Fasting triglycerides ≥ 150 mg/dL
- HDL < 40 mg/dL (men) or < 50 mg/dL (women)
- Blood pressure ≥ 130/85 or on antihypertensive treatment
- Fasting glucose ≥ 100 mg/dL or on glucose-lowering treatment

## Genetic context
- TCF7L2 — strongest common genetic risk factor for type 2 diabetes
- FTO — appetite regulation and body weight
- PPARG — insulin sensitivity and fat storage
- MTNR1B — fasting glucose regulation

## What works
- 5-10% body weight loss reverses many components
- Resistance training improves insulin sensitivity independent of weight
- Lower-carb or Mediterranean patterns both work — adherence matters most
- Walking after meals attenuates post-prandial glucose
- Adequate sleep — one night of short sleep raises insulin resistance acutely

## Related (knowledge graph)

### Genes
- TCF7L2 (/genes/tcf7l2): TCF7L2 is the strongest common genetic risk factor for type 2 diabetes within metabolic syndrome. [Strong evidence]
- FTO (/genes/fto): FTO variants raise body-weight set point and the likelihood of meeting metabolic-syndrome criteria. [Moderate evidence]

## FAQ
**Q: Can metabolic syndrome be reversed?**
A: Yes, in most cases — particularly with 5-10% body weight loss, consistent exercise, and reducing ultra-processed food. Even when full reversal isn't possible, the components are individually treatable.

**Q: Does TCF7L2 mean I'll get diabetes?**
A: It raises risk but doesn't determine outcome. TCF7L2 carriers benefit especially from carbohydrate quality, weight management and exercise.

## Citations
- Grant et al., Nat Genet 2006 (PMID 16415884): TCF7L2 variants substantially increase type 2 diabetes risk.

Disclaimer: Informational only — not medical advice.