In the Lancet 27th June 2008 the clinical usefulness of the Metabolic Syndrome. is challenged.
The metabolic syndrome is a collection of risks for insulin resistance and vascular disease under two principle headings
Cardiovascular risk.
Global diabetes or cardiovascular risk.
Smoking, physical inactivity , unhealthy eating
Hypertension
Inflammation, hypercoagulation
Age, race, sex, family history
Abnormal lipid metabolism
Overweight and obesity

Insulin resistance syndrome.
Genetics and age
Increased lipids
Hypertension
Increased blood glucose.

The response of the clinical world is
Criteria are ambiguous or incomplete and the rationale for thresholds ill-defined.
Is adding diabetes useful
No clear basis for including or excluding other cardiovascular risk factors.
Cardiovascular risk factors are variable.
Treatment of this syndrome is no different from the sum of its parts.
Most importantly the medical value of diagnosing the syndrome is unclear.
This review clearly reflects the day to day experience of clinicians rather than the needs of nutrition scientists.
Kahn R 2008 Metabolic syndrome – what is the clinical usefulness The Lancet vol 371 pp 1892-3
Sattar et al 2008 Can metabolic syndrome usefully predict cardiovascular disease and diabetes? Outcome data from two prospective studies Lancet vol 371 pp1927-35

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Martin Eastwood

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