Diabetologia
Volume 48, Number 9, 1684-1699, DOI: 10.1007/s00125-005-1876-2

Published in partnership with the

Logo

European Association for the Study of Diabetes

Review

The metabolic syndrome: time for a critical appraisal
Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes

R. Kahn, J. Buse, E. Ferrannini and M. Stern

View Related Documents

Abstract

Background  

The term lsquometabolic syndromersquo refers to a clustering of specific cardiovascular disease (CVD) risk factors whose underlying pathophysiology is thought to be related to insulin resistance.

Methods  

Since the term is widely used in research and clinical practice, we undertook an extensive review of the literature in relation to the syndromersquos definition, underlying pathogenesis, association with cardiovascular disease and to the goals and impact of treatment.

Discussion  

While there is no question that certain CVD risk factors are prone to cluster, we found that the metabolic syndrome has been imprecisely defined, there is a lack of certainty regarding its pathogenesis, and there is considerable doubt regarding its value as a CVD risk marker. Our analysis indicates that too much critically important information is missing to warrant its designation as a lsquosyndromersquo.

Conclusion  

Until much-needed research is completed, clinicians should evaluate and treat all CVD risk factors without regard to whether a patient meets the criteria for diagnosis of the lsquometabolic syndromersquo.

Keywords  Cardiovascular disease - Cardiovascular risk factors - Insulin resistance syndrome - Metabolic syndrome

This statement was reviewed and approved by the Professional Practice Committee of the American Diabetes Association and by an ad hoc committee of the European Association for the Study of Diabetes (members: H. Beck-Nielsen [Odense, Denmark], K. Borch-Johnsen [Gentofte, Denmark], E. A. M. Gale [Bristol, UK], L. Groop [Malmö, Sweden], H.-U. Häring [Tübingen, Germany], R. J. Heine [Amsterdam, The Netherlands], and D. R. Matthews [Oxford, UK]).
Simultaneous publication: This article is being simultaneously published in 2005 in Diabetes Care and Diabetologia by the American Diabetes Association and the European Association for the Study of Diabetes.
Copyright 2005 by the American Diabetes Association, Inc. and Springer-Verlag. Copying with attribution allowed for any noncommercial use of the work.

Fulltext Preview

Image of the first page of the fulltext document