Metabolic Syndrome: An Evolving Clinical Construct

Metabolic syndrome (MetS), a clustering of metabolic risk factors, identifies individuals at increased risk of diabetes and cardiovascular disease (CVD). Measurement of waist circumference, high-density lipoprotein-cholesterol, triglycerides, blood pressure and fasting blood glucose are easily obtained in the clinic. At any level of low-density lipoprotein-cholesterol, presence of MetS increases the risk of adverse CVD outcomes including bothatherosclerotic CVD and atrial fibrillation. The MetS construct should focus the clinician on recommending behavioral lifestyle modification as this improves all of its components. The challenge, however, has been the lack of a standardized approach to achieve effective and sustained lifestyle modification in clinical practice. We briefly review various approaches useful to the clinician in counseling such patients. These include group lifestyle programs and emerging mobile technology. Technology alone may not be sufficient, but as an adjunct has the promise to improve low rates of behavioral change currently seen with traditional programs.