439
Views
94
CrossRef citations to date
0
Altmetric
Clinical Focus: Risk Reduction and Treatment of Metabolic and Vascular Disorders

Metabolic Syndrome: Definition and Therapeutic Implications

, MD, , MD, , MD & , MD
Pages 21-30 | Published online: 13 Mar 2015

References

  • . Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960-1994. Int J Obes Relat Metab Disord. 1998;22(1):39–47
  • . Eckel RH, Krauss RM. American Heart Association call to action: obesity as a major risk factor for coronary heart disease. AHA Nutrition Committee. Circulation. 1998;97(21):2099–2100
  • . Sun SS, Liang R, Huang TT,. Childhood obesity predicts adult metabolic syndrome: the Fels Longitudinal Study. J Pediatr. 2008; 152(2):191–200
  • . Reaven GM. Banting Lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988;37:1595–1607
  • . Eckel RH, Grundy SM, Zimmet PZ. Metabolic syndrome. Lancet. 2005;365(9468):1415–1428
  • . Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486–2497
  • . Alberti KG, Zimmet P, Shaw J. Metabolic syndrome—a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med. 2006;23(5):469–480
  • . Grundy SM, Cleeman JI, Daniels SR,; American Heart Association; National Heart, Lung, and Blood Institute. Diagnosis and management of metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112(17):2735–2752
  • . Ford ES, Giles WH, Dietz WH. Prevalence of metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA. 2002;287(3):356–359
  • . Ford ES. Prevalence of metabolic syndrome defined by the International Diabetes Federation among adults in the U.S. Diabetes Care. 2005;28(11):2745–2749
  • . Park YW, Zhu S, Palaniappan L, Heshka S, Carnethorn MR, Heymsfield SB. Metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med. 2003; 163(4): 427–436
  • . Palaniappan L, Carnethon MR, Wang Y,. Predictors of the incident metabolic syndrome in adults: the Insulin Resistance Atherosclerosis Study. Diabetes Care. 2004;27(3):788–793
  • . Hamdy O, Porramatikul S, Al–Ozairi E. Metabolic obesity: the paradox between visceral and subcutaneous fat. Curr Diabetes Rev. 2006;2(4):367–373
  • . Manson JE, Skerrett PJ, Greenland P,. The escalating pandemics of obesity and sedentary lifestyle. A call to action for clinicians. Arch Intern Med. 2004;164(3):249–258
  • . Ferreira I, Twisk JW, van Mechelen W, Kemper HC, Stehouwer CD. Development of fatness, fitness, and lifestyle from adolescence to the age of 36 years: determinants of metabolic syndrome in young adults: the Amsterdam growth and health longitudinal study. Arch Intern Med. 2005;165(1):42–48
  • . Fauci AS, Braunwald E, Kasper DL,. The metabolic syndrome. In: Harrison's Principles of Internal Medicine. Ch. 236. New York, NY: McGraw-Hill Medical; 2008
  • . Alexander CM, Landsman PB, Teutsch SM, Haffner SM; Third National Health and Nutrition Examination Survey (NHANES III); National Cholesterol Education Program (NCEP). NCEP-defined metabolic syndrome, diabetes, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes. 2003;52:1210–1214
  • . Lamberti JS, Olson D, Crilly JF,. Prevalence of the metabolic syndrome among patients receiving clozapine. Am J Psychiatry. 2006;163(7):1273–1276
  • . Koh KK, Han SH, Quon MJ. Inflammatory markers and metabolic syndrome insights from therapeutic interventions. J Am Coll Cardiol. 2005;46(11):1978–1985
  • . Ridker, PM, Buring, JE, Cook, NR,. C-reactive protein, metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14 719 initially healthy American women. Circulation. 2003;107(3):391–397
  • . Festa A, D'Agostino R Jr, Howard G, Mykkänen L, Tracy RP, Haffner SM. Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation. 2000;102(1):42–47
  • . Ridker PM. Clinical application of C-reactive protein for cardiovascular disease detection and prevention. Circulation. 2003;107(3):363–369
  • . Festa A, D'Agostino R Jr, Tracy RP,. Elevated levels of acute-phase proteins and plasminogen activator inhibitor-1 predict the development of type 2 diabetes: the insulin resistance atherosclerosis study. Diabetes. 2002;51(4):1131–1137
  • . Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA. 2001;286(3):327–334
  • . Hu FB, Meigs JB, Li TY,. Inflammatory markers and risk of developing type 2 diabetes in women. Diabetes. 2004;53(6):693–700
  • . Rutter MK, Meigs JB, Sullivan LM, D'Agostino RB Sr, Wilson PW. C-reactive protein, metabolic syndrome, and prediction of cardiovascular events in the Framingham Offspring Study. Circulation. 2004;110(4):380–385
  • . Lopez–Candales A. Metabolic syndrome X: a comprehensive review of the pathophysiology and recommended therapy. J Med. 2001;32(5–6):283–300
  • . Pearson TA, Mensah GA, Alexander RW,. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003;107(3):499–511
  • . Manson JE, Skerrett PJ, Greenland P, Vanltallie TB. The escalating pandemics of obesity and sedentary lifestyle. A call to action for clinicians. Arch Intern Med. 2004;164(3):249–258
  • . Grundy SM, Hansen B, Smith SC Jr,. Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on Scientific issues related to management. Circulation. 2004;109(4):551–556
  • . Jeppesen J, Hansen TW, Rasmussen S, Ibsen H, Torp–Pedersen C, Masbad S. Insulin resistance, metabolic syndrome, and risk of incident cardiovascular disease: a population-based study. J Am Coll Cardiol. 2007;49(21):2112–2119
  • . Girman CJ, Rhodes T, Mercuri M,. The metabolic syndrome and risk of major coronary events in the Scandinavian Simvastatin Survival Study (4S) and the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS). Am J Cardiol. 2004;93(2): 136–141
  • . Ninomiya JK, L'Italien G, Criqui MH, Whyte JL, Gamst A, Chen RS. Association of metabolic syndrome with history of myocardial infarction and stroke in the Third National Health and Nutrition Examination Survey. Circulation. 2004;109(1):42–46
  • . Dekker JM, Girman C, Rhodes T,. Metabolic syndrome and 10-year cardiovascular disease risk in the Hoorn Study. Circulation. 2005;112(5):666–673
  • . Wannamethee SG, Shaper AG, Lennon L, Morris R W. Metabolic syndrome vs Framingham Risk Score for prediction of coronary heart disease, stroke, and type 2 diabetes mellitus. Arch Intern Med. 2005;165(22):2644–2650
  • . Hong Y, Jin X, Mo J,. Metabolic syndrome, its preeminent clusters, incident coronary heart disease and all-cause mortality—results of prospective analysis for the Atherosclerosis Risk in Communities study. J Intern Med. 2007;262(1):113–122
  • . Gami AS, Witt BJ, Howard DE,. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007;49(4):403–414
  • . Ford ES. Risks for all-cause mortality, cardiovascular disease, and diabetes associated with metabolic syndrome: a summary of the evidence. Diabetes Care. 2005;28(7):1769–1778
  • . Galassi A, Reynolds K, He J. Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med. 2006;119(10):812–819
  • . Malik S, Wong ND, Franklin SS,. Impact of metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults. Circulation. 2004;110(10):1245–1250
  • . Sattar N, McConnachie A, Shaper AG,. Can metabolic syndrome usefully predict cardiovascular disease and diabetes? Outcome data from two prospective studies. Lancet. 2008;371(9628):1927–1935
  • . Bruno G, Merletti F, Biggeri A,; Casale Monferrato Study. Metabolic syndrome as a predictor of all-cause and cardiovascular mortality in type 2 diabetes: the Casale Monferrato Study. Diabetes Care. 2004;27(11):2689–2694
  • . Kahn R, Buse J, Ferrannini E,. Metabolic syndrome: time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2005;28(9):2289–2304
  • . Grundy SM. Metabolic syndrome: connecting and reconciling cardiovascular and diabetes worlds. J Am Coll Cardiol. 2006;47(6):1093–1100
  • . Kannel WB, Larson M. Long-term epidemiologic prediction of coronary disease. The Framingham experience. Cardiology. 1993;82(2–3):137–152
  • . Golden SH, Folsom AR, Coresh J,. Risk factor groupings related to insulin resistance and their synergistic effects on subclinical atherosclerosis: the Atherosclerosis Risk in Communities Study. Diabetes. 2002;51(10):3069–3076
  • . Laaksonen DE, Lakka HM, Niskanen LK, Kaplan GA, Salonen JT, Lakka TA. Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Am J Epidemiol. 2002;156(11):1070–1077
  • . Cornier MA, Dabelea D, Hernandez TL,. Metabolic syndrome definitions of metabolic syndrome in a prospective cohort study. Endocr Rev. 2008;29(7):777–822
  • . Hanson RL, Imperatore G, Bennett PH,. Components of the “metabolic syndrome” and incidence of type 2 diabetes. Diabetes. 2002;51(10):3120–3127
  • . Lebovitz HE. Type 2 diabetes: an overview. Clin Chem. 1999;45(8 pt 2): 1339–1345
  • . de Vegt F, Dekker JM, Jager A,. Relation of impaired fasting and postload glucose with incident type 2 diabetes in a Dutch population: the Hoorn Study. JAMA. 2001;285(16):2109–2113
  • . Lloyd–Jones DM, Liu K, Colangelo LA,. Consistently stable or decreased body mass index in young adulthood and longitudinal changes in metabolic syndrome components: the Coronary Artery Risk Development in Young Adults Study. Circulation. 2007;115(8):1004–1011
  • . Pasanisi F, Contaldo F, de Simone G, Mancini M. benefits of sustained moderate weight loss in obesity. Nutr Metab Cardiovasc Dis. 2001;11(6):401–406
  • . Ilanne–Parikka P, Eriksson JG, Lindstrom J,; Finnish Diabetes Prevention Study Group. Effect of lifestyle intervention on the occurrence of metabolic syndrome and its components in the Finnish Diabetes Prevention Study. Diabetes Care. 2008;31(4):805–807
  • . Orchard TJ, Temprosa M, Goldberg R,; Diabetes Prevention Program Research Group. The effect of metformin and intensive lifestyle intervention on metabolic syndrome: the Diabetes Prevention Program Randomized Trial. Ann Intern Med. 2005;142(8):611–619
  • . Jenkins DJ, Kendall CW, Augustin LS,. Glycemic index: overview of implications in health and disease. Am J Clin Nutr. 2002;76(1):266S–273S
  • . McKeown NM, Meigs JB, Liu S, Saltzman E, Wilson PW, Jacques PF. Carbohydrate nutrition, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort. Diabetes Care. 2004;27(2):538–546
  • . Mayer EJ, Newman B, Quesenberry Jr CP, Selby JV. Usual dietary fat intake and insulin concentrations in healthy women twins. Diabetes Care. 1993;16(11):1459–1469
  • . Maron DJ, Fair JM, Haskell WL. Saturated fat intake and insulin resistance in men with coronary artery disease. The Stanford Coronary Risk Intervention Project Investigators and Staff. Circulation. 1991;84(5):2020–2027
  • . Hu FB, Stampfer MJ, Manson JE,. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med. 1997;337(21): 1491–1499
  • . Sacks FM, Svetkey LP, Vollmer WM,. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 2001;344(1):3–10
  • . Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM; American Heart Association. Dietary approaches to prevent and treat hypertension: a Scientific statement from the American Heart Association. Hypertension. 2006;47(2):296–308
  • . Chobanian AV, Bakris GL, Black HR,; Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206–1252
  • . Whelton PK, He J, Cutler JA,. Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA. 1997;277(20):1624–1632
  • . American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the diagnosis and treatment of hypertension. Endocr Pract. 2006;12(2):193–222
  • . Ohkawara K, Tanaka S, Miyachi M, Ishikawa–Takata K, Tabata I. A dose-response relation between aerobic exercise and visceral fat reduction: systematic review of clinical trials. Int J Obes (Lond). 2007;31(12):1786–1797
  • . Ross R, Janssen I, Dawson J,. Exercise-induced reduction in obesity and insulin resistance in women: a randomized controlled trial. Obes Res. 2004;12(5):789–798
  • . Haskell WL, Lee IM, Pate RR,; American College of Sports Medicine; American Heart Association. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):1081–1093
  • . Dengel DR, Pratley RE, Hagberg JM, Rogus EM, Goldberg AP. Distinct effects of aerobic exercise training and weight loss on glucose homeostasis in obese sedentary men. J Appl Physiol. 1996;81(1): 318–325
  • . Ryan AS, Nicklas BJ, Berman DM. Aerobic exercise is necessary to improve glucose utilization with moderate weight loss in women. Obesity (Silver Spring). 2006;14(6):1064–1072
  • . Kelley GA, Kelley KS, Vu TZ. Aerobic exercise, lipids and lipoproteins in overweight and obese adults: a meta-analysis of randomized controlled trials. Int J Obes (Lond). 2005;29(2):881–893
  • . Kelley GA, Kelley KS. Effects of aerobic exercise on lipids and lipoproteins in adults with type 2 diabetes: a meta-analysis of randomized-controlled trials. Public Health. 2007;121(9):643–655
  • . Kodama S, Tanaka S, Saito K,. Effect of aerobic exercise training on serum levels of high density lipoprotein cholesterol: a meta-analysis. Arch Intern Med. 2007;167(10):999–1008
  • . Whelton SP, Chin A, Xin X,. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med. 2002;136(7):493–503
  • . Bacon SL, Sherwood A, Hinderliter A, Blumenthal JA. Effects of exercise, diet and weight loss on high blood pressure. Sports Med. 2004;34(5):307–316
  • . Torgerson JS, Hauptman J, Boldrin MN,. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care. 2004;27(1):155–161
  • . Nathan DM, Buse JB, Davidson MB,. Management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2006;29(8):1963–1972
  • . Knowler WC, Barrett–Connor E, Fowler SE,. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393–403
  • . ; DREAM (Diabetes Reduction Assessment with ramipril and rosiglitazone Medication) Trial InvestigatorsGerstein HC, Yusuf S, Bosch J,. Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial. Lancet. 2006;368(9541):1096–1105
  • . Nissen SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med. 2007;356(24):2457–2471
  • . Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, Laakso M; STOP-NIDDM Trial Research Group. Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial. Lancet. 2002;359(9323):2072–2077
  • . Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143–3421
  • . Bakker–Arkema RG, Davidson MH, Goldstein RJ,. efficacy and safety of a new HMG-CoA reductase inhibitor, atorvastatin, in patients with hypertriglyceridemia. JAMA. 1996;275:128–133
  • . McFarlane SI, Muniyappa R, Francisco R,. Clinical review 145: pleiotropic effects of statins: lipid reduction and beyond. J Clin Endocrinol Metab. 2002;87(4):1451–1458
  • . Pyörälä K, Ballantyne CM, Gumbiner B,. Reduction of cardiovascular events by simvastatin in nondiabetic coronary heart disease patients with and without metabolic syndrome: subgroup analyses of the Scandinavian Simvastatin Survival Study (4S). Diabetes Care. 2004;27:1735–1740
  • . Deedwania P, Barter P, Carmena R,. Reduction of low-density lipoprotein cholesterol in patients with coronary heart disease and metabolic syndrome: analysis of the Treating to New Targets study. Lancet. 2006;368(9539):919–928
  • . Turley SD, Dietschy JM. The intestinal absorption of biliary and dietary cholesterol as a drug target for lowering the plasma cholesterol level. Prev Cardiol. 2003;6(1):29–33, 64
  • . Dujovne CA, Ettinger MP, McNeer JF,. efficacy and safety of a potent new selective cholesterol absorption inhibitor, ezetimibe, in patients with primary hypercholesterolemia. Am J Cardiol. 2002;90:1092–1097
  • . Simons L, Tonkon M, Masana L,. Effects of ezetimibe added to on-going statin therapy on the lipid profile of hypercholesterolemic patients with diabetes mellitus or metabolic syndrome. Curr Med Res Opin. 2004;20(9):1437–1445
  • . Kastelein JJ, Akdim F, Stroes ES,; ENHANCE Investigators. Simvastatin with or without ezetimibe in familial hypercholesterolemia. N Engl J Med. 2008;358(14):1431–1443
  • . Leaf DA, Connor WE, Illingworth DR,. The hypolipidemic effects of gemfibrozil in type V hyperlipidemia. A double-blind, crossover study. JAMA. 1989;262(22):3154–3160
  • . Frick MH, Elo O, Haapa K,. Helsinki Heart Study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease. N Engl J Med. 1987;317(20):1237–1245
  • . Kashyap ML, McGovern ME, Berra K,. Long-term safety and efficacy of a once daily niacin/lovastatin formulation for patients with dyslipidemia. Am J Cardiol. 2002;89:672–678
  • . AIM-HIGH Investigators. The role of niacin in raising high-density lipoprotein cholesterol to reduce cardiovascular events in patients with atherosclerotic cardiovascular disease and optimally treated low-density lipoprotein cholesterol rationale and study design. The Atherothrombosis Intervention in Metabolic syndrome with low HDL/high triglycerides: Impact on Global Health outcomes (AIM-HIGH). Am Heart J. 2011;161(3):471–477.e2
  • . Israili ZH, Lyoussi B, Hernández–Hernández R, Velasco M. Metabolic syndrome: treatment of hypertensive patients. Am J Ther. 2007; 14(4):386–402
  • . Barnett AH, Bain SC, Bouter P,; Diabetics Exposed to Telmisartan and Enalapril Study Group. Angiotensin-receptor blockade versus converting-enzyme inhibition in type 2 diabetes and nephropathy. N Engl J Med. 2004;351(19):1952–1961
  • . Wright Jr JT, Harris–Haywood S, Pressel S,. Clinical outcomes by race in hypertensive patients with and without metabolic syndrome: Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Arch Intern Med. 2008;168(2):207–217
  • . Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS. UK Prospective Diabetes Study Group. BMJ. 1998;317(7160):713–720
  • . Buchwald H, Avidor Y, Braunwald E,. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–1737
  • . Folli F, Pontiroli AE, Schwesinger WH. Metabolic aspects of bariatric surgery. Med Clin North Am. 2007;91(3):393–414
  • . Sjöström L, Narbro K, Sjostrom CD,. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–752
  • . Cull CA, Jensen CC, Retnakaran R,. Impact of metabolic syndrome on macrovascular and microvascular outcomes in type 2 diabetes mellitus: United Kingdom Prospective Diabetes Study 78. Circulation. 2007;116(19):2119–2126
  • . Ferrannini E. Metabolic syndrome: a solution in search of a problem. J Clin Endocrinol Metab. 2007;92(2):396–398

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.