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: 8.42). 08/2006; 29(7):1689-92; discussion 1693-6. DOI: 10.2337/dc05-2307
Source: PubMed


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.

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    • "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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    • "The etiology of DM and related conditions e.g. PCOS, cardiovascular disease(s), etc; are not clearly understood[34] although there are well accepted techniques for their diagnosis and treatment. Most tests are insufficiently sensitive to diagnose the prevalence of disease from its earliest origins. "
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    ABSTRACT: This article discusses factors which materially influence the diagnosis, prevention and treatment of diabetes mellitus but which may be overlooked by the prevailing biomedical paradigm. That cognition can be mathematically linked to the function of the autonomic nervous system and physiological systems casts new light upon the mechanisms responsible for homeostasis and origins of disease. In particular, it highlights the limitations of the reductionist biomedical approach which considers mainly the biochemistry of single pathologies rather than considering the neural mechanisms which regulate the function of physiological systems, and inherent visceral organs; and which are subsequently manifest as biochemistries of varying degrees of complexity and severity. As a consequence, histopathological tests are fraught with inherent limitations and many categories of drugs are significantly ineffective. Such limitations may be explained if disease (in particular diabetes mellitus) has multiple origins, is multi-systemic in nature and, depending upon the characteristics of each pathology, is influenced by genotype and/or phenotype. This article highlights the influence of factors which are not yet considered re. the aetiology of diabetes mellitus e.g. the influence of light and sensory input upon the stability of the autonomic nervous system; the influence of raised plasma viscosity upon rates of reaction; the influence of viruses and/or of modified live viruses given in vaccinations; systemic instability, in particular the adverse influence of drinks and lack of exercise upon the body's prevailing pH and its subsequent influence upon levels of magnesium and other essential trace elements. This application of the top-down systems biology approach may provide a plausible and inclusive explanation for the nature and occurrence of diabetes mellitus.
    North American Journal of Medical Sciences 10/2010; 2(10):444-56. DOI:10.4297/najms.2010.2444
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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 · 2.34 Impact Factor
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