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(Circulation. 2007;115:1806-1811.)
© 2007 American Heart Association, Inc.

Controversies in Cardiovascular Medicine

Is the metabolic syndrome a real syndrome?

Metabolic Syndrome

Is It a Syndrome? Does It Matter?

Richard Kahn, PhD

From the American Diabetes Association, Alexandria, Va.

Correspondence to Richard Kahn, PhD, c/o American Diabetes Association, 1701 N Beauregard St, Alexandria, VA 22311. E-mail RKahn@diabetes.org

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
To provide useful answers to the title questions, the first issue to resolve is what is meant by the term "metabolic syndrome." If it is supposed to refer to a loose clustering of signs that are associated with cardiovascular disease (CVD) and type 2 diabetes mellitus, which can largely be ascribed to what we conceptually call "insulin resistance," then the term may have some utility. However, if the term represents a very specific algorithm that should be used to diagnose a unique disease, it is highly misleading and ineffective. Unfortunately, many proponents of the term write about and discuss it as if both meanings are interchangeable, and as a result, they effectively blur all the problems that have arisen when referring to the term, confuse practitioners who are unable to easily understand the distinction, and do clinical medicine a great disservice. Let’s look closely at the issues.

Response by Beaser and Levy p 1811

	The Syndrome as a Concept

 
For several decades, we have had many terms that represented a clustering of signs related to CVD and diabetes mellitus that seemed to occur more often than chance would dictate. Certainly, an aggregate of signs associated with a morbid process that together constitute the picture of a disease may be rightly called a syndrome. In the early days, many investigators put a name to the condition that reflected its "metabolic"^1–3 or "insulin resistance"⁴ origin. At that time, the cluster referred to the presence of obesity, hyperglycemia, hypertension, hyperlipidemia, and sometimes hyperuricemia. Reaven, in his now classic . . . [Full Text of this Article]

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