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Syndrome X: is it for real?

J V Neel1, S Julius, A Weder

  • 1Department of Human Genetics, University of Michigan Medical School, Ann Arbor, USA.

Genetic Epidemiology
|April 2, 1998
PubMed
Summary

Syndrome X, the cluster of hypertension, non-insulin-dependent diabetes mellitus (NIDDM), and obesity, lacks a unifying cause. The association is driven by body mass index (BMI) and hypertension, not a distinct syndrome. Genetic factors were also considered.

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Area of Science:

  • Epidemiology
  • Metabolic Syndrome Research
  • Genetics

Background:

  • Syndrome X, also known as metabolic syndrome, describes a cluster of conditions including hypertension, non-insulin-dependent diabetes mellitus (NIDDM), obesity, insulin resistance, and dyslipidemia.
  • The concept of Syndrome X posits a single underlying pathophysiology unifying these interrelated metabolic and cardiovascular risk factors.
  • Previous research has suggested a syndrome-like association, but the validity of a unifying pathophysiology requires further investigation in diverse populations.

Purpose of the Study:

  • To investigate the validity of Syndrome X as a distinct entity with a unifying pathophysiology.
  • To analyze the associations between hypertension, non-insulin-dependent diabetes mellitus (NIDDM), and body mass index (BMI) in population samples.
  • To explore potential genetic influences on the observed trait associations.

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Main Methods:

  • Population-based samples from Tecumseh, Michigan, and Hiroshima, Japan, including individuals aged 40 years and older.
  • Analysis of hypertension, NIDDM, and BMI using chi-squared tests and log-linear models.
  • Stratification by age (≥40, ≥50 years) and obesity (BMI ≥27, ≥30) to assess interactions.

Main Results:

  • Non-random associations were found between hypertension, NIDDM, and BMI, with an excess of individuals exhibiting all three traits.
  • Log-linear analyses revealed no significant three-factor interaction (Syndrome X), indicating a lack of a unifying pathophysiology.
  • A significant two-factor interaction was observed between BMI and hypertension, suggesting this pair drives the observed associations.

Conclusions:

  • The data do not support the existence of Syndrome X as a distinct entity with a single unifying cause.
  • The observed association between hypertension, NIDDM, and BMI is primarily driven by the interaction between BMI and hypertension.
  • Further research is needed to elucidate the complex interplay of genetic and environmental factors contributing to these metabolic and cardiovascular risk factors.