Metabolic syndrome X: a comprehensive review of the pathophysiology and recommended therapy

Diabetes mellitus is associated with a markedly increase prevalence of coronary artery disease, found to be as high as 55% (Lyons, 1993). The metabolic syndrome X, a multifaceted clinical entity produced by genetic, hormonal and lifestyle factors which occurs frequently in the general population, has been associated as an end point in patients with diabetes (Timar, Sestier et al., 2000). New data suggests that a clustering of truncal obesity, glucose intolerance or non-insulin dependent diabetes mellitus, dyslipidemia and essential hypertension are key components of this metabolic syndrome X (Timar, Sestier et al., 2000). In fact, the metabolic syndrome X has been shown to precede frank diabetes in a substantial number of patients; hence similar multiple cardiac risk factors will be found in this population. Thus, primary care providers should identify patients at an early stage so that appropriate treatment can be readily instituted. The goal of this review is to summarize criteria for diagnosis of patients with the metabolic syndrome X and therapeutic targets of each individual component is analyzed in a attempt to reduce cardiovascular events and improve clinical outcome based on the available clinical data.