CONTROVERSY IN CLINICAL ENDOCRINOLOGY Metabolic Syndrome: A Multiplex Cardiovascular Risk

Context: The metabolic syndrome (MetS) is a multiplex risk factor for cardiovascular disease. The syndrome develops through interplay of obesity and metabolic susceptibility. Objective: This article addresses whether the MetS construct has clinical utility. Position: The National Cholesterol Education Program and other organizations have proposed that the MetS can be recognized clini-cally by a clustering of simple clinical measures including waist cir-cumferences, blood pressure, triglycerides, high-density lipoproteins, and glucose. People with this clustering have most or all of the com-ponents of the MetS. Identifying the MetS has several advantages. It discovers persons who are at increased risk for cardiovascular dis-ease. A diagnosis focuses more clinical attention on the underlying causes, notably obesity and other lifestyle factors; it thereby rein-forces the utility of lifestyle changes in clinical practice. A diagnosi