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[The metabolic syndrome does not exist].

J C Seidell1

  • 1Vrije Universiteit, Faculteit Aard- en Levenswetenschappen, afd. Voeding en Gezondheid, De Boelelaan, HV Amsterdam. jaap.seidell@falw.vu.nl

Nederlands Tijdschrift Voor Geneeskunde
|May 2, 2007
PubMed
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The metabolic syndrome, a cluster of conditions including obesity, high blood pressure, and type 2 diabetes, may not be a distinct medical diagnosis. Its components appear to carry individual risks without synergistic effects on coronary disease.

Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Metabolic Disorders

Background:

  • A cluster of conditions including masculine obesity patterns, hypertension, atherosclerosis, and type 2 diabetes mellitus (T2DM) is observed more frequently than by chance.
  • The definition of a syndrome typically aids diagnosis, prognosis, and understanding of pathophysiological mechanisms.

Purpose of the Study:

  • To critically evaluate the concept and clinical utility of the "metabolic syndrome" as a distinct diagnostic entity.

Main Methods:

  • Review of existing literature and clinical data regarding the metabolic syndrome and its individual components.
  • Analysis of the independent and combined risks associated with hypertension, atherosclerosis, T2DM, and specific fat distribution patterns.

Main Results:

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  • Individuals with the metabolic syndrome do not exhibit a significantly higher risk of coronary disease than predicted by their individual risk factors.
  • The pathophysiology underlying the metabolic syndrome remains obscure, evidenced by the varied manifestation of risk factors among affected individuals.
  • No specific treatment exists for the metabolic syndrome beyond managing its constituent conditions.

Conclusions:

  • The metabolic syndrome lacks a clear pathophysiological basis and does not confer additional cardiovascular risk beyond its individual components.
  • The current concept of the metabolic syndrome may not be clinically useful, suggesting it may not represent a distinct medical entity.