[The metabolic syndrome and insulin resistance]

The frequency of cardiovascular disease associated with metabolic disorder is increasing rapidly worldwide. The metabolic syndrome, a concurrence of glucose intolerance, obesity, dyslipidemia, and hypertension that are risk factors for atherosclerosis, accounts for a large proportion of cardiovascular morbidity and mortality. Exceeding energy intake coupled with high fat diet, sedentary lifestyle, and multiple genetic factors interact to produce the metabolic syndrome, and insulin resistance and visceral adiposity have been suggested to be the common pathophysiological basis of the metabolic syndrome. Adiposity is correlated with altered production of so-called adipocytokines that play a role on the atherosclerotic angiopathy. At the cellular level, excess insulin is involved in VLDL-triglycerides production, decreased HDL, and various elements of atherogenesis. Detecting the metabolic syndrome and implementing preventive lifestyle interventions--diet education, physical activity, and weight control--is a high clinical priority.