Metabolic syndrome

The metabolic syndrome, also known as the dysmetabolic syndrome, metabolic syndrome X, or insulin resistance syndrome, is a major public health concern worlwide. The growing obesity epidemic is its most noticeable effect, but the metabolic syndrome can be present in the absence of frank obesity. Almost one fourth of Americans have metabolic syndrome, and the proportion keeps raising.

The metabolic syndrome is defined by the World Health Organisation using the following criteria :

• Insulin resistance, identified by one of the following:
  • Type 2 diabetes
  • Impaired fasting glucose
  • Impaired glucose tolerance
  • or, for those with normal fasting glucose levels (<110mg/dL), glucose uptake below the lowest quartile for background population under investigation under hyperinsulinemic, euglycemic conditions
• in conjunction with any two of the following:
  • Antihypertensive medication and/or high blood pressure (≥140mmHg systolic or ≥90mmHg diastolic)
  • Plasma triglycerides ≥150mg/dL (≥1.7mmol/L)
  • HDL cholesterol <35mg/dL (0.9mmol/L) in men or <39mg/dL (1.0mmol/L) in women
  • BMI (Body Mass Index) >30kg/m² and/or waist:hip ratio >0.9 in men, >0.85 in women
  • Urinary albumin excretion rate ≥20μmg/g or albumin: creatinine ratio ≥30 mg/g.

The metabolic syndrome is thus a cluster of risk factors for diabetes and cardiovascular diseases. The syndrome includes proinflammatory and prothrombotic features.

The metabolic syndrome could also promote the development of cancer, polycystic ovary syndrome (PCOS), and nonalcoholic fatty liver disease".