Abstract

Metabolic syndrome, encompassing abdominal obesity, dysglycemia, arterial hypertension and atherogenic dyslipidemia, is increasingly encountered in patients with colorectal disease and is relevant as both an epidemiological and a perioperative risk factor. This narrative review summarizes current evidence on associations between metabolic syndrome and its components with colorectal cancer, diverticular disease and inflammatory bowel disease, and evaluates their effects on colorectal surgical outcomes. The most consistent associations concern visceral obesity and dysglycemia. These conditions are linked to colorectal neoplasia, surgical-site infection, technical complexity and anastomotic leakage. Computed-tomography assessment of visceral adiposity may provide more useful risk information than body mass index alone, although measurement methods and cutoffs remain heterogeneous. Evidence for arterial hypertension and dyslipidemia is less specific, and their effects are probably mediated by vascular comorbidity, chronic inflammation and thrombotic mechanisms. Evidence for diverticular disease and inflammatory bowel disease remains heterogeneous. Perioperative assessment should therefore focus on individual risk components, including visceral adiposity, glycemic control, cardiovascular and thrombotic risk, nutritional status and procedure-related factors. This approach may improve risk stratification and guide preoperative optimization, prevention of infectious and thromboembolic complications, and postoperative monitoring.
 

Keywords

metabolic syndrome; visceral obesity; colorectal neoplasms; diverticular disease; inflammatory bowel diseases; colorectal surgery; postoperative complications.

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