Circulation. 2004;109:551-556
doi: 10.1161/01.CIR.0000112379.88385.67
doi: 10.1161/01.CIR.0000112379.88385.67
(Circulation. 2004;109:551-556.)
© 2004 American Heart Association, Inc.
AHA/NHLBI/ADA Conference Proceedings |
Clinical Management of Metabolic Syndrome
Report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association Conference on Scientific Issues Related to Management
*Conference Participants: Augustus O. Grant, MD, PhD; James I. Cleeman, MD; Scott M. Grundy, MD, PhD; Barbara C. Hansen, PhD; Robert H. Eckel, MD; F. Xavier Pi-Sunyer, MD; William C. Knowler, MD; Barry A. Franklin, PhD; Claude Bouchard, PhD; Rena R. Wing, PhD; Frank M. Sacks, MD; Henry N. Ginsberg, MD; Robert A. Hegele, MD; Alan R. Shuldiner, MD; H. Bryan Brewer, Jr, MD; Ronald M. Krauss, MD; James R. Sowers, MD; Ahmed Kissebah, MD; Daniel Porte, Jr, MD; Edward S. Horton, MD; Sidney C. Smith, Jr, MD; Russell P. Tracy, PhD; Thomas A. Pearson, MD, MPH, PhD; Steven M. Haffner, MD; Peter O. Kwiterovich, Jr, MD; and Abhumanyu Garg, MD.
Key Words: AHA Scientific Statements • metabolic syndrome • diabetes mellitus • cardiovascular diseases • obesity
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
The National Cholesterol Education Program’s Adult Treatment Panel III report (ATP III)1 identified the metabolic syndrome as a multiplex risk factor for cardiovascular disease (CVD) that is deserving of more clinical attention. Subsequently, the National Heart, Lung, and Blood Institute (NHLBI), in collaboration with the American Heart Association (AHA), convened a conference to examine scientific issues related to definition of the metabolic syndrome.2 The present report summarizes a second conference devoted to clinical management of the metabolic syndrome, which was sponsored by the AHA in partnership with the NHLBI and cosponsored by the American Diabetes Association (ADA). This latter conference considered the following issues: (1) pathogenesis and presentation of the metabolic syndrome, (2) management of underlying risk factors, (3) management of metabolic risk factors, and (4) unresolved issues and research challenges.
The conference on definition2 confirmed CVD as a major clinical outcome of metabolic syndrome and identified 6 major components of the syndrome: abdominal obesity, atherogenic dyslipidemia, elevated blood pressure, insulin resistance ± glucose intolerance, a proinflammatory state, and a prothrombotic state. The follow-up conference on management was structured around therapies for these components. Clinical recognition of the metabolic syndrome is generally based on finding several well-recognized signs in clinical practice: abdominal obesity, elevated triglycerides, reduced HDL cholesterol, raised blood pressure, and elevated plasma glucose. In addition, research shows that other components not routinely measured commonly aggregate with the major components: elevated apolipoprotein B, small LDL particles, insulin resistance and hyperinsulinemia, impaired glucose tolerance (IGT), elevated C-reactive protein (CRP), and
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