16 June 2009

Is Metabolic Syndrome for real or just a popular clinical tool?

Cardiovascular disease and diabetes have several inter-related risk factors that may include obesity, high-cholesterol, high-triglycerides, hypertension, insulin resistance and inflammation (1). All these separate conditions can be treated in various ways. But why not lump them all together: metabolic syndrome?

Combining the cluster of risk factors into one condition remains controversial among scientists. On one side of the coin are those that metabolic syndrome provides a greater perspective for treating and managing reduction of all factors to avoid future problems (1;2). On the other side of the coin are those who find that evidence is not reliable enough and that more work is needed before risk factors can be chosen before defining metabolic syndrome as a clinical tool (3-6).

Clinicians, however, can rest assured that while research should continue into metabolic syndrome, the current definition of the condition can be helpful. According to a systemic review and meta-analysis published in 2007 by Mayo Clinic on 43 cohorts, there was a strong association of “increased risk of cardiovascular events” with those with metabolic syndrome (7). Thus, ultimately, the most recent data suggest that using metabolic syndrome as a clinical tool for treating and counseling patients shows great promise.

Reference List

1. Lien LF, Guyton JR. Metabolic syndrome. Dermatol Ther 2008;21:362-75.
2. Gallagher EJ, LeRoith D, Karnieli E. The metabolic syndrome--from insulin resistance to obesity and diabetes. Endocrinol Metab Clin North Am 2008;37:559-79, vii.
3. Schweiger C, Cirrincione V, Ignone G. [Metabolic syndrome: a true syndrome or only a cluster of risk factors?]. G Ital Cardiol (Rome) 2008;9:67S-73S.
4. Balkau B, Valensi P, Eschwege E, Slama G. A review of the metabolic syndrome. Diabetes Metab 2007;33:405-13.
5. Brietzke SA. Controversy in diagnosis and management of the metabolic syndrome. Med Clin North Am 2007;91:1041-viii.
6. Cheng AY, Leiter LA. Metabolic syndrome under fire: weighing in on the truth. Can J Cardiol 2006;22:379-82.
7. 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;49:403-14.

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