Document Type : Editorial
Masoumeh Sadeghi MD, Assistant Professor, CVD in Women Research Unit, Isfahan Cardiovascular Research Center.
IntroductionThe metabolic syndrome - the clustering ofabdominal obesity, dyslipidemia, hyperglycemia andhypertension - is a major public health challengeworldwide.1,2 The metabolic syndrome is not benign;it is associated with a substantially elevated risk oftype 2 diabetes (5-fold) and of cardiovascular disease(CVD) (2-3-fold),1 and its increasing prevalence couldpossibly reverse the gains made through recentdeclining CVD mortality.The metabolic syndrome is not a new condition. Itwas first described in the 1920s by Kylin, a Swedishphysician, as the association of hypertension,hyperglycemia and gout.3 In the 1940s, attention wasdrawn to upper body adiposity (android or male-typeobesity) as the obesity phenotype commonlyassociated with type 2 diabetes and CVD.4This constellation of CVD risk factors has been givena number of names, including "deadly quartet","syndrome X", and "insulin resistance syndrome",1but "metabolic syndrome" is likely to hold sway forthe foreseeable future.Just as the metabolic syndrome has borne a variety ofdifferent names, numerous definitions have alsosurfaced. The World Health Organization definition,5and two others, developed by the European Groupfor the Study of Insulin Resistance6 and the NationalCholesterol Education Program - Third AdultTreatment Panel (ATP III),7 have been the main onesin use. Each of these agreed on the core componentsof obesity, hyperglycemia, dyslipidemia andhypertension. However, the definitions differ in thecut-points used for each component, and the way inwhich the components are combined, leading toconsiderable confusion.1 The confusion has beenparticularly apparent in attempts to compare theburden in different populations, where the use ofdifferent definitions has seriously hampered theability to make comparisons between and withincommunities.1,2