The metabolic syndrome

It has long been known that certain cardiovascular and metabolic risk factors tend to cluster together. For example, in the 1940s the French clinician, Vague, described the diabetic and atherogenic risk associated with android (upper body) obesity. The relatively recent concept of a metabolic syndrome suggested that the clustering represents a discrete entity due to a single underlying aetiology (insulin resistance). Yet, despite several definitions and its own International Classification of Diseases code its validity and utility remains unclear. The evidence does not fully support the existence of a single underlying aetiology, and most, but not all, evidence suggests that the syndrome as currently defined appears to have little value in predicting cardiovascular disease risk over other approaches that consider individual risk factors. At present there is no specific treatment for the syndrome other than targeting the individual risk factors. It is concluded that at this time its main utility is as a reminder to the clinician that certain risk factors tend to cluster, and as an indicator of the public health importance of the risk factor clustering associated with obesity and physical inactivity