Metabolic syndrome: an evolving threat in the genesis of coronary artery disease

Cardiovascular disease is an escalating worldwide health problem. Effective tools to predict and prevent its development and progression are needed. Correctly diagnosing the metabolic syndrome, which identifies people at higher risk for developing diabetes mellitus and cardiovascular disease, may be valuable in guiding treatment and prevention of these major disorders. Several important definitions of the metabolic syndrome have been proposed. The authors discuss these definitions and how they vary in terms of their relationship to incident cardiovascular disease, type 2 diabetes mellitus, and surrogate markers of atherosclerosis. Establishing clarity on what is meant by the metabolic syndrome and agreement as to its underlying basis is needed to reach consensus between the many different definitions that have been proposed. This is particularly the case if it is to become a useful adjunct in clinical practice to identify those who may benefit from more intensive lifestyle interventions and more detailed short-term risk assessments.