Editing Metabolic syndrome (section)

== Signs and symptoms ==
The key sign of metabolic syndrome is [[central obesity]], also known as visceral, male-pattern or apple-shaped adiposity. It is characterized by [[adipose tissue]] accumulation predominantly around the waist and trunk.<ref>{{Cite web |date=15 January 2019 |title=Metabolic Syndrome |url=http://www.diabetes.co.uk/diabetes-and-metabolic-syndrome.html |website=Diabetes.co.uk}}</ref> Other signs of metabolic syndrome include high blood pressure, decreased fasting serum HDL cholesterol, elevated fasting serum [[triglyceride]] level, [[impaired fasting glucose]], insulin resistance, or prediabetes. Associated conditions include [[hyperuricemia]]; [[fatty liver]] (especially in concurrent [[obesity]]) progressing to [[nonalcoholic fatty liver disease]]; [[polycystic ovarian syndrome]] in women and [[erectile dysfunction]] in men; and [[acanthosis nigricans]].<ref>{{Cite journal |display-authors=6 |vauthors=Mendrick DL, Diehl AM, Topor LS, Dietert RR, Will Y, La Merrill MA, Bouret S, Varma V, Hastings KL, Schug TT, Emeigh Hart SG, Burleson FG |date=March 2018 |title=Metabolic Syndrome and Associated Diseases: From the Bench to the Clinic |journal=Toxicological Sciences |volume=162 |issue=1 |pages=36–42 |doi=10.1093/toxsci/kfx233 |pmc=6256950 |pmid=29106690}}</ref>

=== Neck circumference ===
Neck circumference has been used as a surrogate simple and reliable index to indicate upper-body subcutaneous fat accumulation. Neck circumference of more than {{cvt|40.25|cm}} for men and more than {{cvt|35.75|cm}} for women are considered high-risk for metabolic syndrome. Persons with large neck circumferences have a more-than-double risk of metabolic syndrome.<ref>{{Cite journal |last=Mohseni-Takalloo |first=Sahar |last2=Mozaffari-Khosravi |first2=Hassan |last3=Mohseni |first3=Hadis |last4=Mirzaei |first4=Masoud |last5=Hosseinzadeh |first5=Mahdieh |date=2023-06-13 |title=Evaluating Neck Circumference as an Independent Predictor of Metabolic Syndrome and Its Components Among Adults: A Population-Based Study |journal=Cureus |language=en |volume=15 |issue=6 |pages=e40379 |doi=10.7759/cureus.40379 |issn=2168-8184 |pmc=10344419 |pmid=37456431 |doi-access=free}}</ref> In adults with overweight/obesity, clinically significant weight loss may protect against COVID-19<ref>{{Cite journal |last=Shyam |first=Sangeetha |last2=García-Gavilán |first2=Jesús Francisco |last3=Paz-Graniel |first3=Indira |last4=Gaforio |first4=José J. |last5=Martínez-González |first5=Miguel Ángel |last6=Corella |first6=Dolores |last7=Martínez |first7=J. Alfredo |last8=Alonso-Gómez |first8=Ángel M. |last9=Wärnberg |first9=Julia |last10=Vioque |first10=Jesús |last11=Romaguera |first11=Dora |last12=López-Miranda |first12=José |last13=Estruch |first13=Ramon |last14=Tinahones |first14=Francisco J. |last15=Lapetra |first15=José |date=2023-10-13 |title=Association of adiposity and its changes over time with COVID-19 risk in older adults with overweight/obesity and metabolic syndrome: a longitudinal evaluation in the PREDIMED-Plus cohort |journal=BMC Medicine |language=en |volume=21 |issue=1 |page=390 |doi=10.1186/s12916-023-03079-z |issn=1741-7015 |pmc=10576302 |pmid=37833678 |doi-access=free}}</ref> and neck circumference has been associated with the risk of being mechanically ventilated in COVID-19 patients, with a 26% increased risk for each centimeter increase in neck circumference.<ref>{{Cite journal |last=Di Bella |first=Stefano |last2=Cesareo |first2=Roberto |last3=De Cristofaro |first3=Paolo |last4=Palermo |first4=Andrea |last5=Sanson |first5=Gianfranco |last6=Roman-Pognuz |first6=Erik |last7=Zerbato |first7=Verena |last8=Manfrini |first8=Silvia |last9=Giacomazzi |first9=Donatella |last10=Dal Bo |first10=Eugenia |last11=Sambataro |first11=Gianluca |last12=Macchini |first12=Elisabetta |last13=Quintavalle |first13=Francesco |last14=Campagna |first14=Giuseppe |last15=Masala |first15=Renato |date=2021 |title=Neck circumference as reliable predictor of mechanical ventilation support in adult inpatients with COVID-19: A multicentric prospective evaluation |journal=Diabetes/Metabolism Research and Reviews |language=en |volume=37 |issue=1 |pages=e3354 |doi=10.1002/dmrr.3354 |issn=1520-7552 |pmc=7300447 |pmid=32484298}}</ref> Moreover, hospitalized COVID-19 patients with a "large neck phenotype" on admission had a more than double risk of death.<ref>{{Cite journal |last=Di Bella |first=Stefano |last2=Zerbato |first2=Verena |last3=Sanson |first3=Gianfranco |last4=Roman-Pognuz |first4=Erik |last5=De Cristofaro |first5=Paolo |last6=Palermo |first6=Andrea |last7=Valentini |first7=Michael |last8=Gobbo |first8=Ylenia |last9=Jaracz |first9=Anna Wladyslawa |last10=Bozic Hrzica |first10=Elizabeta |last11=Bresani-Salvi |first11=Cristiane Campello |last12=Galindo |first12=Alexandre Bezerra |last13=Crovella |first13=Sergio |last14=Luzzati |first14=Roberto |date=2021-12-10 |title=Neck Circumference Predicts Mortality in Hospitalized COVID-19 Patients |journal=Infectious Disease Reports |language=en |volume=13 |issue=4 |pages=1053–60 |doi=10.3390/idr13040096 |issn=2036-7449 |pmc=8700782 |pmid=34940406 |doi-access=free}}</ref>

=== Complications ===
Metabolic syndrome can lead to several serious and chronic complications, including [[Type 2 diabetes|type-2 diabetes]], [[cardiovascular disease]]s, [[stroke]], [[kidney disease]] and [[Non-alcoholic fatty liver disease|nonalcoholic fatty liver disease.]]<ref>{{Cite web |title=Metabolic syndrome – Symptoms and causes |url=https://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916 |access-date=2022-03-31 |website=Mayo Clinic |language=en}}</ref>

Furthermore, metabolic syndrome is associated with a significantly increased risk of surgical complications across most types of surgery in a 2023 systematic review and meta-analysis of over 13 million individuals.<ref>{{Cite journal |last=Norris |first=Philip |last2=Gow |first2=Jeff |last3=Arthur |first3=Thomas |last4=Conway |first4=Aaron |last5=Fleming |first5=Fergal J |last6=Ralph |first6=Nicholas |date=2 November 2023 |title=Metabolic syndrome and surgical complications: A systematic review and meta-analysis of 13 million individuals |journal=International Journal of Surgery |volume=110 |issue=1 |pages=541–53 |doi=10.1097/JS9.0000000000000834 |pmc=10793842 |pmid=37916943 |doi-access=free}}</ref>