The concept of cardiometabolic risk: Bridging the fields of diabetology and cardiology

Figures & data

Table I.  Advantages and limitations of the clinical diagnosis of the metabolic syndrome.

Advantages	Limitations
• Independently from the clinical criteria used, metabolic syndrome is associated with a 1.5- to 2-fold increase in CVD risk.	• Clinical diagnosis of the metabolic syndrome does not assess global risk of CVD.
• Improves CVD risk prediction on top of currently available risk factors.	• Diagnosis of the metabolic syndrome does not appear to predict CVD risk beyond the sum of its individual components.
• Identifies high-risk subjects that are not necessarily identified by currently available risk algorithms.	• Treatment of the metabolic syndrome does not appear to be different than treatment of individual abnormalities.
• Independently from etiology, there is clear pathophysiological evidence linking features of the metabolic syndrome to atherogenesis.	• Etiology of metabolic syndrome is still unclear (debate between abdominal obesity and insulin resistance).
• Life-style interventions improve features of the metabolic syndrome and decrease CVD and diabetes risk	• No clear rationale for cutoff values of proposed clinical criteria for its diagnosis.
	• Severity of the syndrome not assessed by current approaches.
	• Added value questioned in clinical practice.

CVD: cardiovascular disease.

Figure 1.  Schematic representation of the assessment of global cardiometabolic risk using traditional risk factors and emerging cardiovascular disease risk markers.

Figure 2.  Plasma: C-reactive protein (CRP) levels (top) and visceral adipose tissue accumulation measured by computed tomography (bottom) in men with the hypertriglyceridemic waist phenotype (waist ≥90 cm and triglycerides ≥2.0 mmol/L) and in men with both a low waist circumference and low plasma triglyceride levels.

Figure 3.  The combination of an increased waist girth along with elevated plasma triglycerides is a good clinical marker of excess intra-abdominal adipose tissue accumulation and might represent a simple and inexpensive screening tool to identify patients with features of the metabolic syndrome.