Clinical benefits of the new definitions of the metabolic syndrome

Abstract

The metabolic syndrome can most simply be defined as an inter-related cluster of risk factors for diabetes and cardiovascular disease. Over the last decade, several different sets of diagnostic criteria have been generated. This has caused confusion, although all include a measure of obesity, dysglycemia, raised triglycerides and low high-density lipoprotein-cholesterol (HDL-C) raised blood pressure and, implicitly, insulin resistance. Most recently, the International Diabetes Federation (IDF) and the American Heart Association (AHA)/National Heart, Lung and Blood Institute (NHLBI) have produced similar criteria, although differing in waist measurement, which is lower, ethnically adjusted and obligatory in the IDF recommendations. There has been arguments as to both the etiology and clinical utility of the syndrome. In general, it provides a useful tool for use in primary care to screen people for increased relative risk of both cardiovascular disease and diabetes. There has been an explosion of interest in the metabolic syndrome over the past two decades. However, there have been a plethora of diagnostic criteria, dissenting views on pathogenesis, arguments about clinical usefulness and differences of opinion regarding the predictive power of the syndrome. In the following editorial we shall discuss the historical development of the syndrome and attempts to generate diagnostic sets, and argue that, with the most recent criteria produced by the IDF and the AHA/NHLBL, we now have a valuable and easy-to-use clinical tool of great potential benefit to patients.