Should we dump the metabolic syndrome? No

A heated debate on the metabolic syndrome has been ongoing for several years now. However, amidst the various doubts surrounding the existence of the syndrome, a key figure, which theoretically should be at the center of this debate, has instead been consistently ignored: the patient. If the metabolic syndrome were to be accepted as a distinct clinical entity, it would be inappropriate, in my opinion, to hide such a diagnosis from our patients. But what would their reaction be upon learning of their apparently new disease? “Oh no! I have the metabolic syndrome!” or perhaps “I knew that I’m fat, have high blood pressure and diabetes, but no one ever talked to me about the metabolic syndrome!”.

Personally, although I always keep the potential pathophysiological mechanisms underlying the metabolic syndrome in the back of my mind, I never explicitly use the term when discussing risk factor modification with my patients. I prefer to examine each risk factor separately and define therapeutic goals in a schematic manner that is easy to understand. Without a doubt, the concept of metabolic syndrome is intellectually appealing, but from a practical standpoint its routine clinical application may serve only to create unnecessary confusion and anxiety among patients.

Competing interests: None declared