Establishing Clear Criteria for Metabolic Syndrome

Metabolic syndrome is characterized by interrelated risk factors for cardiovascular disease (CVD) and diabetes, including dysglycemia, hypertension, raised triglyceride levels, low HDL cholesterol levels, and obesity, specifically central adiposity. Patients with metabolic syndrome are twice as likely to develop CVD over the next 5 to 10 years when compared with those without it. In addition, metabolic syndrome has been associated with a five-fold increase in risk for type 2 diabetes. Clarifying the Definition To unify the diagnostic criteria for metabolic syndrome, the International Diabetes Federation (IDF) recently issued a scientific statement in conjunction with the National Heart, Lung, and Blood Institute, American Heart Association, World Heart Federation, International Atherosclerosis Society, and International Association for the Study of Obesity. The statement, published in the October 19, 2009 issue of Circulation, defines terminology and criteria related to metabolic syndrome in an effort to clarify incongruencies presented by different organizations over the past decade. “It’s our hope that this joint statement will eliminate confusion and assist physicians with the identification and treatment of patients who have metabolic syndrome,” says Robert H. Eckel, MD, FAHA, a co-author of the scientific statement. Metabolic syndrome was first defined by a group at the World Health Organization in 1998; it emphasized insulin resistance as the major underlying risk factor. In 2001, the National Cholesterol Education Program Adult Treatment Panel-III (ATP III) characterized the syndrome as the presence of three of five risk factors (abdominal obesity, elevated triglycerides, low HDL cholesterol, high blood pressure, and elevated fasting glucose) with or without evidence of insulin resistance. Subsequently, the IDF established an alternative definition that required a threshold waist...