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Should we dump the metabolic syndrome?: Yes

BMJ 2008; 336 doi: (Published 20 March 2008) Cite this as: BMJ 2008;336:640
  1. Edwin A M Gale, professor of diabetes
  1. 1Diabetes and Metabolism, University of Bristol, Medical School Unit, Southmead Hospital, Bristol BS10 5NB
  1. Edwin.Gale{at}

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

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

Unclear definition

A cluster of clinical features constitutes a syndrome, but attempts to define the metabolic syndrome as a clinical entity have been hampered by the lack of an agreed unifying feature. The grouping was first described in patients with type 2 diabetes,1 …

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