The metabolic syndrome

Although the metabolic syndrome has existed in various forms and definitions for more than eight decades, only in the past 5 years has real controversy about its definition and significance emerged. 1 Kahn R Buse J Ferrannini E Stern M The metabolic syndrome: time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2005; 28: 2289-2304 Crossref PubMed Scopus (1720) Google Scholar The main controversy was that the syndrome had had too many definitions and there was a lack of clarity about its role and value in clinical practice. And it is fair to say, with exception, 2 Gami AS Witt BJ Howard DE et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007; 49: 403-414 Summary Full Text Full Text PDF PubMed Scopus (1404) Google Scholar that most of the published reports indicate that the syndrome does not predict cardiovascular events or disease progression any better than the sum of its components. 3 Wannamethee SG Shaper AG Lennon L Morris RW Metabolic syndrome vs Framingham risk score for prediction of coronary heart disease, stroke, and type 2 diabetes mellitus. Arch Intern Med. 2005; 165: 2644-2650 Crossref PubMed Scopus (510) Google Scholar , 4 Koskinen J Kahonen M Viikari JS et al. Conventional cardiovascular risk factors and metabolic syndrome in predicting carotid intima-media thickness progression in young adults: the cardiovascular risk in young Finns study. Circulation. 2009; 120: 229-236 Crossref PubMed Scopus (134) Google Scholar The relative value in predicting type 2 diabetes remains uncertain. 5 Ford ES Li C Sattar N Metabolic syndrome and incident diabetes: current state of the evidence. Diabetes Care. 2008; 31: 1898-1904 Crossref PubMed Scopus (404) Google Scholar