Evolution of metabolic syndrome and its biomarkers

The evolution of human from ancient times to modern era has witnessed several environmental and social changes which contributed to genetic and epigenetic makeup of human beings and in turn is responsible for its present phenotype. In the recent past, owing to socioeconomic developmental pressure, a large epidemiologic shift towards non-communicable disease pattern has been noticed in many developing countries including India which resulted into incidence of diabetes and cardiovascular diseases in epidemic proportion. These two pathologies form a subset associated with metabolic derangement, popularly termed as metabolic syndrome. Earlier its status and the pathophysiological rationale were largely obscure and hence it was given a rather disguised name - Syndrome X, as an icon of unknown. While initially contemplated to be an endocrine problem associated with insulin resistance, the scientific insight about this pathology has undergone a gradual evolution. Therefore the pathogenic and consequent diagnostic modality consistently changed. Quite fascinatingly its phenomenal conversion from an endocrine etiopathology to an inflammatory pathogenesis has imprinted a paradigm shift. From laboratory medicine perspective, these evidences have immense impact to steer the research towards development of the apposite diagnostic modality for this very significant and nationally relevant health problem.