Metabolic Syndrome: Pathophysiology, Clinical Implications, and Management Strategies

Abstract

Metabolic syndrome is a complex disorder characterized by a cluster of conditions, including insulin resistance, obesity, dyslipidaemia, and hypertension, which collectively elevate the risk of cardiovascular disease and type 2 diabetes mellitus and its significant impact on patients with lung diseases such as chronic obstructive pulmonary disease (COPD), asthma, and interstitial lung disease (ILD). This review explores the pathophysiology of Metbolic Syndrome, emphasizing the roles of insulin resistance, chronic inflammation, the complex interplay between MetS and lung diseases, focusing on systemic inflammation, oxidative stress, and immune system activation in its development. These factors exacerbate pulmonary symptoms and contribute to multi-organ complications, including cardiovascular disease, non-alcoholic fatty liver disease (NAFLD), chronic kidney disease (CKD), and cognitive decline. Clinical implications are discussed, highlighting the increased risks of cardiovascular disease, cognitive impairment, and frailty, particularly in older adults and specific gender groups. Management strategies, such as lifestyle interventions, pharmacological treatments, and novel therapeutic approaches like sacubitril/valsartan and telmisartan, are reviewed to underscore the importance of early intervention. This review also highlights the importance of a multidisciplinary approach to management, integrating lifestyle modifications, pharmacological interventions (e.g., statins, GLP-1 agonists), and emerging therapies (e.g., senolytics, gut-lung axis modulation). The paper concludes with a call for targeted therapies to address the underlying mechanisms of Metabolic Syndrome in high-risk populations and by addressing pulmonary components, such strategies aim to improve patient outcomes and reduce morbidity and mortality.