BMJ  2008;336:641 (22 March), doi:10.1136/bmj.39484.636586.94

Head to Head

Should we dump the metabolic syndrome? No

¹ Department of Endocrinology and Metabolism, St Mary’s Hospital and Imperial College, London, ² International Diabetes Institute, Melbourne, Australia

doi: 10.1136/bmj.39477.500197.AD

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

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

The clustering of several disorders associated with increased risk of cardiovascular disease has been recognised for over 80 years,¹making claims that the drug industry invented the syndrome lack credibility. However, the modern concept of the metabolic syndrome started in 1988 with Reaven describing the clustering of insulin resistance, hyperinsulinaemia, glucose intolerance, hypertension, raised triglyceride concentration, and low high density lipoprotein cholesterol concentration.² Over the next decade other features, most notably central obesity, were found to be associated with this cluster. There was little argument about the existence of the clustering but confusion about its diagnosis. Different criteria abounded, the most widely used coming from the World Health Organization³ and the National Cholesterol Education Programme (adult treatment panel III).⁴ The International Diabetes Federation then brought the various groups together recommending a diagnostic set⁵ which was similar to the updated version of adult treatment panel III.⁶

Recognising that the syndrome provides . . . [Full text of this article]

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