The Metabolic Syndrome in Mid-Aged Women

The metabolic syndrome (METS) is diagnosed by the presence of three of the following findings: obesity, hyperglycemia, hypertriglyceridemia, low high-density lipoprotein cholesterol, and hypertension. Many features of the syndrome are related to insulin resistance and excessive weight. Diagnostic criteria may vary from one institution to another and the prevalence of the METS, and its components, increases after the menopause, with age and sedentary lifestyle. The syndrome is accompanied with alterations of cytokines, digestive hormones, and antioxidative capacity. Associated comorbidities include among others insulin resistance and type 2 diabetes mellitus, cardiovascular disease, and other conditions such as sexual dysfunction, insomnia, genitourinary pathology, and cognitive impairment. Clinical interventions for the METS include diet and appropriate nutrition, exercise, preservation of the ovarian function and hormone therapy, and/or individual treatment of each of its components. The Mediterranean diet improves insulin sensitivity, produces favorable metabolic changes, and modifies the digestive microbioma. Regular vigorous exercise reduces body weight and potentiates the effects of a healthy diet. Menopausal hormone therapy may be considered if indicated for specific complaints.