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What is a Metabolic Syndrome?

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By Sergey Skudaev

A Metabolic Syndrome is a cluster of risk factors for cardiovascular disease (CVD) and type 2 diabetes. Swedish physician Eskil Kylin offered a concept of the Metabolic Syndrome in 1923.[4]

There is no agreement yet, which risk factors should be included in the Metabolic Syndrome. The World Heath Organization (WHO) definition of the Metabolic Syndrome requires the presence of type 2 diabetes, impaired glucose tolerance, or insulin resistance, and at least two of the following: hypertension, obesity, raised triglycerides or low HDL cholesterol and microalbuminuria.[1]

The definition of the European Group for the Study of Insulin Resistance (EGIR) requires insulin resistance and at least 2 of the following risk factors: central obesity, with waist circumference of 94/80 cm in men and women consequently, dyslipidemia (raised triglycerides or low HDL cholesterol); hyperglycemia excluding diabetes; and blood pressure > 140/90 mm Hg or treatment for hypertension.

The National Cholesterol Education Program Adult Treatment Panel III (ATP III) requires 3 of the following 5 risk factors: waist circumference > 102 cm in men, 88 cm in women; HDL cholesterol < 40 mg/dL in men, <50 mg/dL in women; triglycerides > 150 mg/dL, blood pressure > 130/85 mm Hg; and fasting serum glucose > 110 (later 100) mg/dL.

The International Diabetes federation (IFD) conference worked out an agreement on the Metabolic Syndrome definition. According to this consensus, the Metabolic Syndrome must include adiposity (measure of waist circumference), increased triglycerides or decreased HDL, increased blood pressure, and dysglycemia. [2]

Very important risk factors for CVD and diabetes, which are not included in the Metabolic Syndrome, are raised LDL cholesterol, cigarette smoking, gender and family history.

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1. Alberti KGMM, Zimmer PZ; for the WHO consultation group. Definition, Diagnosis and classification of diabetes mellitus and its complications. Pt 1. Diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabetes Med. 1998;15:539-553.

2.Alberti KGMM, Zimmer P, Shaw J; IDF Epidemiology Task Force Consensus Group. The Metabolic Syndrome -a new worldwide definition. Lancet. 2005;366:1059-1062.

3. Horton ES, Alberti G, Kahn RA. Current issues: the Metabolic Syndrome. Program and abstract of the American Diabetes Association 66th Scientific Sessions: June 9-13, 2006; Washington, D.C.

4. Kylin E. Studien uber das hypertonie-hyperglykamie-hyperurikamiesyndrom. Zentrabl finnere Med. Leipz. 1923;81:105-127

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