It is generally regarded as being associated with:
- A proinflammatory state
- A prothrombotic state
Subgroups of patients may meet the definition of MetS but on follow up not be shown to be strictly at increased risk of cardiovascular disease, a paradox that for example may apply in polycystic ovary syndrome. It is therefore important to realize that we are not dealing with a disease but rather a useful classification associated with epidemiological risk in general populations. The status for example of the apparent metabolic syndrome associated with prolonged high relative intakes of fructose is unclear. This runs the risk of reification and the myths associated with the label metabolic syndrome have been explored. Those that use the label have to recognize that it is not an independent predictor of vascular risk in the elderly, precisely the group most at risk of vascular disease.
There are several recent definitions, made from different viewpoints which has epidemiological implications:
- International Diabetes Federation (IDF) - 2005
- American Heart Association/National Heart Lung and Blood Institute (AHA/NHLBI) - 2004
- National Cholesterol Education Program-Adult Treatment Panel-III (NCEP-ATP-III) - 2001
For example cardiovascular disease prevalence is greater for the last two definitions in some populations.
The concept has been extended to children and adolescents.
|International Diabetes Federation (2005)||NCEP-ATP-III||AHA/NHLBI (2004)||WHO (1999)|
|| Three of:
- ↑ Gale EA. Should we dump the metabolic syndrome? Yes. BMJ (Clinical research ed.). 2008 Mar 22; 336(7645):640.(Link to article – subscription may be required.)
- ↑ Sattar N, McConnachie A, Shaper AG, Blauw GJ, Buckley BM, de Craen AJ, et al. Can metabolic syndrome usefully predict cardiovascular disease and diabetes? Outcome data from two prospective studies. The Lancet Early Online Publication 2008 (http://www.thelancet.com/journals/lancet/article/PIIS0140673608606029/abstract?iseop=true)
- ↑ Alberti KG, Zimmet PZ. Should we dump the metabolic syndrome? No. BMJ (Clinical research ed.). 2008 Mar 22; 336(7645):641.(Link to article – subscription may be required.)
- ↑ Gale EA. The myth of the metabolic syndrome. Diabetologia. 2005 Sep; 48(9):1679-83.(Link to article – subscription may be required.)
- ↑ Sattar N, McConnachie A, Shaper AG, Blauw GJ, Buckley BM, de Craen AJ, Ford I, Forouhi NG, Freeman DJ, Jukema JW, Lennon L, Macfarlane PW, Murphy MB, Packard CJ, Stott DJ, Westendorp RG, Whincup PH, Shepherd J, Wannamethee SG. Can metabolic syndrome usefully predict cardiovascular disease and diabetes? Outcome data from two prospective studies. Lancet. 2008 Jun 7; 371(9628):1927-35.(Link to article – subscription may be required.)
- ↑ Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA : the journal of the American Medical Association. 2001 May 16; 285(19):2486-97.
- ↑ Athyros VG, Ganotakis ES, Elisaf MS, Liberopoulos EN, Goudevenos IA, Karagiannis A. Prevalence of vascular disease in metabolic syndrome using three proposed definitions. International journal of cardiology. 2007 Apr 25; 117(2):204-10.(Link to article – subscription may be required.)
- ↑ Zimmet P, Alberti G, Kaufman F, Tajima N, Silink M, Arslanian S, Wong G, Bennett P, Shaw J, Caprio S. The metabolic syndrome in children and adolescents. Lancet. 2007 Jun 23; 369(9579):2059-61.(Link to article – subscription may be required.)