Should we dump the metabolic syndrome?: Yes

doi:10.1136/bmj.39477.500197.AD

BMJ 2008;336:640 (22 March), doi:10.1136/bmj.39477.500197.AD

Head to Head

Should we dump the metabolic syndrome?: Yes

Edwin A M Gale, professor of diabetes

¹ Diabetes and Metabolism, University of Bristol, Medical School Unit, Southmead Hospital, Bristol BS10 5NB

Edwin.Gale@bristol.ac.uk

doi: 10.1136/bmj.39484.636586.94

The number of people with the metabolic syndrome is rising alongsideobesity. Nevertheless, Edwin Gale believes the diagnosis haslittle practical value. George Alberti and P Z Zimmet, however,think it increases the detection of people at high risk of diabetesand heart disease

The first 150 words of the full text of this article appear below.

Type 2 diabetes and lesser degrees of glucose intolerance areassociated with insulin resistance, central obesity, hypertension,and dyslipidaemia. The term metabolic syndrome describes thesame constellation, with or without glucose intolerance. Althoughthese associations are well established, their pathophysiologicalbasis remains unclear, and no unifying feature has emerged.Attempts have been made to assemble the various features ofthe metabolic syndrome into a single all-purpose definition,for which diagnostic, prognostic, and therapeutic value hasbeen claimed. Diagnosis of the metabolic syndrome is redundantin those who already have diabetes and adds nothing to the managementof those who do not.

A cluster of clinical features constitutes a syndrome, but attemptsto define the metabolic syndrome as a clinical entity have beenhampered by the lack of an agreed unifying feature. The groupingwas first described in patients with type 2 diabetes,¹ and thewider concept of a "metabolic" syndrome . . . [Full text of this article]

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Rapid Responses:

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