Metabolic syndrome might sound like the name of some headbanging rock 'n' roll band or a nefarious, shadowy organization in a pulp novel.

In actuality, it's something even more sinister.

Heart disease, stroke and Type 2 diabetes – that Axis of Bodily Evil – are consequences of metabolic syndrome.

Not a disease per se, metabolic syndrome is an accumulation of risk factors that include high blood sugar levels, high levels of triglycerides (fat) in the blood, low levels of high-density lipoprotein (HDL cholesterol) and abdominal fat.

There was a time not too long ago when many in the medical community would look at diabetes, high cholesterol and high blood pressure as separate, unrelated conditions. But research suggests a strong physiological link among heart disease, hypertension and Type 2 diabetes.

"In recent years, nearly all physicians would acknowledge that metabolic syndrome exists," says Dr. Ishwarlal Jialal, director of the Laboratory for Atherosclerosis and Metabolic Research at UC Davis Medical Center and editor-in-chief of the journal Metabolic Syndrome and Related Disorders. "Now, we need to get on finding a way to treat it."

Call metabolic syndrome a warning sign to patients that they are on the verge of serious medical conditions.

According to the Journal of the American Medical Association, you have metabolic syndrome if you have three of the following five factors:

• Abdominal obesity, with a waist circumference of 40 inches for men and 35 inches for women.

• Elevated triglycerides (at least 150 milligrams per deciliter).

• Reduced HDL (high-density lipoprotein, the so-called "good" cholesterol, 40 milligrams for men, 50 for women).

• Elevated blood pressure (130/85 or higher).

• Mildly elevated fasting blood sugar (110 to 125 milligrams).

No surprise, then, given the nation's rising obesity rate, that a growing number of U.S. citizens qualify as developing metabolic syndrome. The Journal of the American Medical Association puts the figure at 47 million.

Is it an epidemic?

"Well, it's one in four people over 50," Jialal (pronounced jee-LAL) says. "That's a considerable number."

More disturbing, he says, is that he's seeing children at risk at earlier ages than before.

"Go to a junior high around here, and you'll see little kids with Type 2 diabetes and the other aspects of metabolic syndrome," he says. "Their triglycerides are high; HDL, low; and they are overweight and headed for problems."

The good news, Jialal adds, is that metabolic syndrome can be both reversible and preventable. Even better news is that you don't necessarily need to be medicated to get better.

"Diet and exercise," he says. "Sure, like any disease, there could be a genetic component. But I think this disease is largely environmental. We made this for ourselves. It's obesity."

Several studies, most notably 2002 research published in the New England Journal of Medicine, have shown that moderate exercise and a healthy diet curb many of the symptoms of metabolic syndrome.

The study chose sedentary subjects with elevated fasting glucose concentrations – a risk factor for Type 2 diabetes – and put them into a "lifestyle change" (diet and exercise) group, a group receiving the diabetes drug Metformin, and a third group getting a placebo.

Over four years, the lifestyle group, which exercised 30 minutes a day five days a week and ate well, reduced the incidence of diabetes by 58 percent. The group taking medication had a 31 percent reduction.

"It's entirely reversible," Jialal says. "But the more important thing is you can forestall future diabetes and heart disease by treating it early. Don't get to that point."

Another positive: You don't have to lose all that spare tire around your waist. Studies have shown that dropping as little as seven to 10 pounds over a four-year period can significantly reduce the chances of metabolic syndrome.

"Of course, the more you lose, the better," Jialal adds. "There's no doubt that visceral adipose (fat deep in your gut) is driving this syndrome."

Fat stored in the abdomen makes chemicals called cytokines (pronounced SIGHT-o-kines) that inflame the tissues, fat and blood vessels. It also makes it difficult for the body to regulate insulin, which brings glucose to the cells. That forces the pancreas to produce more insulin, which can lead to diabetes.

Jialal is in the midst of a study looking at the positive effects that exercise and weight loss have on cellular inflammation.

"Nobody knows why weight loss and exercise works," he says. "We're trying to define on a cellular level what will happen to the cells (with diet and exercise). But what we do know is that losing weight helps."

Call The Bee's Sam McManis, (916) 321-1145.