Metabolic syndrome's hidden toll on men's health

[WORLD] Metabolic syndrome, a cluster of conditions that significantly increase the risk of heart disease, stroke, and type 2 diabetes, is becoming an increasingly prevalent health concern, particularly among men. As Malaysia transitions into an aging nation, understanding how this syndrome uniquely affects men is crucial for promoting healthy aging and supporting men's vitality throughout their lives.

Metabolic syndrome is characterized by a combination of risk factors that, when occurring together, dramatically increase an individual's risk of developing serious health complications. Dr. Radzi Rodzlan, a consultant nephrologist and internal medicine physician, explains that metabolic syndrome is diagnosed when a person has at least three of the following five risk factors:

• Central obesity (excess fat around the waist)
• High serum triglycerides (too much fat in the blood)
• Low high-density lipoprotein cholesterol (HDL-C, or not enough "good" cholesterol)
• Raised blood pressure
• Raised fasting blood sugar levels

While metabolic syndrome affects both men and women, recent studies have shown that men are at a higher risk. The prevalence of metabolic syndrome among adults in Malaysia is estimated to be between 25% and 40%, with men showing a higher prevalence rate of 24.9% compared to 18.3% in women.

Risk Factors Unique to Men

Several factors contribute to the higher prevalence of metabolic syndrome in men:

Age and Hormonal Changes: As men age, their risk of developing metabolic syndrome increases. This is partly due to declining testosterone levels, which can lead to increased abdominal fat and insulin resistance.

Body Fat Distribution: Men tend to accumulate fat around their midsection, known as "apple-shaped" obesity. This visceral fat is more metabolically active and increases the risk of insulin resistance and cardiovascular disease.

Lifestyle Factors: Men are more likely to engage in behaviors that increase their risk of metabolic syndrome, such as excessive alcohol consumption, smoking, and sedentary lifestyles.

The Impact on Men's Urinary Health

One of the unique ways metabolic syndrome affects men is through its impact on the urinary system. Datuk Dr. Selvalingam Sothilingam, a consultant urologist and robotic surgeon, highlights the connection between metabolic syndrome and various urological conditions:

"There has been increasing evidence that men with metabolic syndrome are at an increased risk of experiencing moderate to severe urinary symptoms as they age," explains Dr. Selvalingam.

These urological issues include:

Benign Prostatic Hyperplasia (BPH): Men with metabolic syndrome are more likely to develop an enlarged prostate, leading to lower urinary tract symptoms (LUTS).

Erectile Dysfunction: The vascular and hormonal changes associated with metabolic syndrome can contribute to erectile problems.

Male Infertility: Metabolic syndrome can affect sperm quality and quantity, potentially impacting fertility.

Increased Risk of Prostate Cancer: Some studies suggest a link between metabolic syndrome and an elevated risk of aggressive prostate cancer.

Kidney Health and Metabolic Syndrome

Metabolic syndrome also has significant implications for men's kidney health. Dr. Radzi explains:

"These changes include decreased glomerular filtration rate (GFR), which is a calculation to measure how well a person's kidneys are working in filtering out waste and extra fluid from their blood, and increased urinary microalbumin, which indicates protein leakage from the kidneys."

These alterations in kidney function can lead to chronic kidney disease (CKD), which may progress to severe health issues, including end-stage kidney disease requiring dialysis or kidney transplantation.

Prevention and Management Strategies

Addressing metabolic syndrome in men requires a multifaceted approach:

Regular Health Screenings: Early detection is crucial. Men should undergo regular health check-ups, including blood pressure, cholesterol, and blood sugar tests.

Lifestyle Modifications:

Exercise: Engaging in regular physical activity, particularly moderate-intensity aerobic exercises, can help combat insulin resistance and improve overall metabolic health.

Healthy Diet: Adopting a balanced diet rich in fruits, vegetables, lean proteins, and whole grains while minimizing processed foods and sugary beverages is essential.

Weight Management: Achieving and maintaining a healthy weight, particularly reducing abdominal fat, is crucial in managing metabolic syndrome.

Medication: In some cases, doctors may prescribe medications to manage specific components of metabolic syndrome, such as high blood pressure or cholesterol.

The Importance of Early Intervention

Dr. Selvalingam stresses the importance of seeking medical attention for urological symptoms:

"Eighty percent of men with BPH can be successfully treated with medication. However, these medications need to be taken long term... Men with complications from BPH may require surgery such as TURP (transurethral resection of prostate), or minimally-invasive treatments such as Rezum (water vapour therapy for the prostate)."

Early intervention can prevent complications such as urinary tract infections, acute urinary obstruction, and in severe cases, kidney failure.

Looking Ahead: Malaysia's Aging Population

As Malaysia's population ages, with projections indicating that by 2040, the elderly population will surpass six million, managing metabolic syndrome in men becomes increasingly crucial. This demographic shift underscores the need for proactive health management and awareness campaigns targeting men's health.

Metabolic syndrome poses unique challenges for men, particularly in terms of urological and kidney health. By understanding these specific risks and implementing preventive strategies, men can take charge of their health and reduce the likelihood of developing serious complications. As Malaysia moves towards an aging population, addressing metabolic syndrome in men will play a vital role in promoting healthy aging and maintaining quality of life for the nation's male population.

Through increased awareness, regular health screenings, and lifestyle modifications, men can significantly reduce their risk of metabolic syndrome and its associated complications. By taking these proactive steps, they can ensure better health outcomes and contribute to the overall well-being of Malaysia's aging population.