The specific cause of the metabolic syndrome remains unknown. Age, hereditary factors and low physical activity are contributing factors.

Efforts have been on to understand  the  intricate patho-physiology of the disease but it has  met with only partial success only.

Fat cells or adipocytes should not be regarded as static storage cells; they are  metabolically  active endocrine cells that are important for a person’s good health. Fat is capable of releasing hormones, enzymes, cytokines and many other important factors that are involved in body metabolism.

If fat becomes static or 'sick' or dysfunctional it is called 'Adiposopathy' and this may have a genetic predisposition. The fat cells sickness maybe  responsible for some of the most common metabolic diseases like type 2 diabetes, hypertension and dyslipidemia.

Metabolic Pathway Defect:  Glucose is the final end product of digestion and is utilized as a fuel by the cells of the body. To push the glucose inside the cells, the pancreas provides a hormone called insulin. However in metabolic syndrome, cells of the body becomes resistant to insulin and this causes high levels of glucose to remain trapped in the blood stream. To overcome this situation the pancreas produces even more insulin. However this excess insulin, though able to push the glucose, also leads to increased mobilization of fat and elevates the level of  cholesterol and triglyceride levels in the blood. This, in turn, damages the coronary arteries.

The majority of the affected individuals are obese, old and sedentary. The primary risk factors, in BRtheir order of importance, are:

1. Age,
2. Family history,
3. Reduced physical activity, and
4. Excess caloric intake

Pro-thrombotic (blood clotting) and pro-inflammatory tendencies are frequently associated with Metabolic syndromes.

These tendencies are indicative of –

Clogged arteries, heart disease and stroke,

Diabetes, and

Kidney disease

Any of these factors can usher in premature death. If left untreated, the conditions that make up the metabolic syndrome can develop complications in as few as 15 years.

Several markers have been identified that are closely associated with Metabolic Syndrome. They include increased levels of-

• C-reactive protein,
• Fibrinogen,
• Interleukin 6 (IL–6)
• Tumor necrosis factor-alpha (TNFá)

Increased oxidative stress due to a variety of factors, such as a rise in uric acid level (trigerred by dietary fructose) are also associated with metabolic syndromes.

Recent research has reflected some other interesting possibilities. In a prospective study that was conducted on 10, 308 men and women employed in 20 London civil service departments, with a follow-up of an average of 14 years, it was found that there was a link between metabolic syndrome and chronic stress at work.

The study done by Chandola et al at the Department of Epidemiology and Public Health, at University College London, concluded that there was evidence for the biological plausibility of an association between psychosocial stressors from everyday life and heart disease.