Does the Metabolic Syndrome Exist?

Department of Clinical Nutrition, Center for Human Nutrition, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Y3.206, Dallas, 75390-9052, USA.
Diabetes Care (Impact Factor: 8.57). 08/2006; 29(7):1689-92; discussion 1693-6. DOI: 10.2337/dc05-2307
Source: PubMed

ABSTRACT The fundamental questions raised by Kahn et al. are 1) whether the wellestablished clustering of metabolic risk factors underlying both CVD and type 2 diabetes deserve to be called a "syndrome" and, 2) even if the metabolic syndrome can be accepted as a concept, whether the concept has matured enough to be introduced into medical practice. The first is a matter of semantics and is controversial because of differences in perspectives and biases of cardiovascular and diabetes communities and individual investigators. Yet the term metabolic syndrome seems to be as good for describing the proven clustering of metabolic risk factors as any alternative. The second question is more substantial and requires considerations of the growing importance of obesity in causation of CVD and diabetes, the need for more intensive lifestyle intervention in clinical risk management, and the necessity for identification of patients in whom multiple risk factors convey greater risk than otherwise recognized by a single-risk factor strategy for CVD and diabetes prevention. There appears to be growing support for moving clinical practice away from the single-risk factor strategy to one that focuses on multiple risk factors, of which the metabolic syndrome is a prime example.

    • "The modernization of contemporary society has brought an increase in obesity and T2DM, both in developed countries such as those in the process of development [15]. In parallel to the increase in these risk factors, cardiovascular disease mortality (CD), especially coronary ischemic heart disease has increased in Costa Rica in recent decades [16]. "
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    ABSTRACT: Objective: To determine associated factors to metabolic syndrome in the populations that participated in the Mexico hospital health fair in February 2007. Materials and Methods: A retrospective, descriptive transverse and analytic study of the population interviewed during the Health Fair held from February 19 to 22. A descriptive analysis was done as well as a single-variable and mul-tivariate analysis of the main variables. Results: San Jose Province reported a higher percentage of cases with 40.7%, followed by Heredia with 26.0% and Alajuela with 24.9%. In the case of Lemon, the percentage was 0.4% only. Most of the interviewed ones are Costa Ricans, representing 94.0%. The female predominance was notorious with 72.6%. The single-variable and multivariate analysis presented an association among blood pressure, glucose, besides of the body mass index related to the metabolic syndrome. Conclusion: The blood pressure, the glucose, and the body mass index are to be considered as associated factors to metabolic syndrome.
    Health 08/2015; 7(8):903-909. DOI:10.4236/health.2015.78106 · 2.10 Impact Factor
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    • "In spite of variations in criteria and thresholds, all definitions agree that the MetS is a cluster of metabolic factors predictive of cardiovascular disease (CVD) risk, and include obesity , high blood pressure, dyslipidemia, and hyperglycemia. Studies have shown that the presence of the MetS adds to the risk of CVD and diabetes (Ford 2005; Grundy 2006; Kurl et al. 2006; Sundström et al. 2006; Lorenzo et al. 2007), although its clinical value is still questioned (Kahn et al. 2005; Reaven 2005), regardless of its epidemiological interest . Both NCEP and IDF definitions may be particularly useful for epidemiological purposes, since they do not require the assessment of insulin resistance. "
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    ABSTRACT: According to two current definitions, the prevalence of the metabolic syndrome (MetS) among black Haitians of Montreal was <20%, 30%-36% in Algonquin Indians of Quebec, and >45% in Mexicans of Oaxaca (all aged 35-60 y). Although phenotypes were different, high triglycerides and fasting dysglycemia were good predictors of MetS in all three groups using both definitions. The international cut-offs for abdominal obesity were not predictive of MetS in the Haitian subjects.
    Applied Physiology Nutrition and Metabolism 04/2008; 33(2):356-60. DOI:10.1139/H08-003 · 2.23 Impact Factor
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    • "Metabolic syndrome diagnosis has been proposed as being clinically useful to identify patients who are at a higher lifetime risk of both CVD and type 2 diabetes and reinforcing lifestyle modification within a multiple risk factor therapeutic strategy (Grundy, 2006b). Indeed, Grundy (2006a) restates that the primary reason why the NCEP ATP III introduced the metabolic syndrome into its clinical guidelines was to emphasize the importance of lifestyle therapy in clinical practice (Grundy, 2006a). "
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    ABSTRACT: We examined the single and combined effects of a 1-year diet and exercise intervention on the International Diabetes Federation (IDF) metabolic syndrome among middle-aged males. The study was a randomized, controlled, 2 x 2 factorial intervention study. Participants included 137 men with metabolic syndrome according to the IDF criteria aged 40-49 years randomly allocated to four intervention groups: diet alone (n=34), exercise alone (n=34), the combination of the diet and exercise intervention (n=43) or control (n=26). The main outcome measure was metabolic syndrome as defined by IDF criteria (2005). In the combined diet and exercise group, 14 participants (32.6%) (P<0.0001 as compared with control) had the metabolic syndrome after 1-year intervention. In the diet-only group, 22 participants (64.7%) (P=0.023 vs control) and in the exercise-only group 26 participants (76.5%) (P=0.23 vs control) had the metabolic syndrome following the intervention. Utilizing the factorial design, both dietary and exercise intervention had significant effects (P<0.005) on the resolution of the metabolic syndrome. Both exercise and dietary intervention reduced metabolic syndrome prevalence compared with control after 1 year of intervention. However, the combined diet and exercise intervention was significantly more effective than diet or exercise alone in the treatment of the metabolic syndrome.
    Scandinavian Journal of Medicine and Science in Sports 12/2007; 17(6):687-95. DOI:10.1111/j.1600-0838.2006.00631.x · 3.17 Impact Factor
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