If I were to say that Mr. John Doe is suffering from Syndrome X, would you suspect that he had been abducted by a UFO and returned infected with an alien strain of bacteria, or that he is at risk for developing diabetes and heart disease? Medical scientists have chosen the strange term Syndrome X or the more user friendly term Metabolic Syndrome to identify a cluster of risk factors that include: 1) Central obesity (a large waist). 2) Moderately elevated blood sugar levels. 3) High triglyceride levels. 4) Low HDL-cholesterol (the "good" cholesterol). 5) High blood pressure. You may be tempted to say, "What's the big deal?" You've been lectured about obesity, fat in the diet, lack of exercise. How is this lecture going to be any different? Well, it's not. The bottom line will always come down to pleas for proper nutrition and more physical activity. The difference has more implications for medical professionals. We are now better able to identify earlier those individuals who are at greatest risk for developing diabetes and/or heart disease. All you need is three of the five above mentioned items to qualify for this newly coined medical diagnosis of Metabolic Syndrome. We used to say that a fasting blood sugar (FBS) of 120 was "OK" or "borderline" and nothing to worry about. No more. The latest knowledge says that FBS levels should not exceed 110 and that even slightly elevated levels are an indication that the body's cells are gradually becoming resistant to insulin, the hormone secreted by the pancreas. As the cells become resistant, more insulin is secreted but the level of sugar in the blood rises because of the cells' increasing resistance. A negative cycle ensues and the pancreas eventually (over the course of years) burns itself out. That is the scenario within the blood stream long before the actual diagnosis of diabetes is made. In fact, a pre-diabetic phase can percolate for up to 10 years before a person experiences symptoms and by then a lot of damage has already been done to the kidneys, blood vessels, heart and eyes. Unless of course, your medical provider becomes suspicious when your waist circumference exceeds 40 inches for men and 35 for women since the high levels of insulin stimulate the body to store fat. We also used to say a blood pressure of 140/90 was "borderline" high and nothing to worry about. No more. Even minimally elevated blood pressures, especially when combined with pre-diabetic states and abnormal lipid metabolism (high cholesterol or high triglyceride levels) contribute to stresses upon the inner walls of arteries leading to the development of arteriosclerosis, commonly called hardening of the arteries and, of course, heart disease. When it came to fats in the blood, a few decades ago we were only concerned with total cholesterol levels. If a level were less that 200 we'd say the patient was doing all right. Now that we know so much more about lipid metabolism, we're able to refine our knowledge more precisely. Even within the last five years the precision has intensified. We used to say that an HDL value of 35 for men and 40 for women was adequate. No more. The statistics now favor HDL values greater than 40 for men and 45 for women. Most of you know your waist size. But if you don't know your fasting blood sugar, your triglyceride, your HDL or your blood pressure please consider finding out. Or, if any of your numbers are "borderline" consider the fact that statistics are stacking against you in favor of bringing those numbers into tighter control. I know it's a lecture you're tired of hearing but, on the other hand, Syndrome X could be your wake up call to avoiding diabetes or heart disease. Agnes Oblas is a nurse practitioner with a private practice and residence in Ahwatukee Foothills. For questions, or if there is a topic you would like her to address, contact her at (602) 405-6320. Her Web site is www.newpathshealth.com.

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