The metabolic syndrome, insulin resistance and cardiovascular disease

In westernised societies the metabolic syndrome (MS) is common and primarily a lifestyle disease with significant morbidity and premature mortality. The main endpoints are related to cardiovascular disease (CVD), especially affecting the heart. Although insulin resistance (and hyperinsulinaemia) is an early marker of MS and future adverse cardiovascular outcomes, it is not known if on its own this is sufficient. The issue is further clouded in prospective studies by the development in study subjects of some, or all of the components of MS, each of which is an independent risk factor for CVD! Therefore, in spite of a number of appropriate long-term observational studies, we are unable to tease out the exact contribution of the individual components of MS, which together are unequivocally responsible for this present-day epidemic of CVD.