Definition and Clinical Relevance of the Metabolic Syndrome

The Metabolic Syndrome (MetS) comprises a cluster of (inter­‐) related risk factors of metabolic origin, promoting the development of cardiovascular disease (CVD) and increasing the risk for development of type 2 diabetes. MetS risk factors are hypertension, dyslipidemia, elevated fasting blood glucose and central obesity. Moreover, physical inactivity, aging and hormonal imbalance contribute to the MetS risk.

Prevalence Rates for the Metabolic Syndrome by Different Definitions

WHO: World Health Organization, 1999; ATP: Adult Treatment Panel III, 1999; EGIR: European Group for the Study of Insulin Resistance, 2001 *only ~9% of individuals meet the criteria for all three definitions

Several organizations as the WHO recommend criteria for the diagnosis of the Metabolic Syndrome. The figure illustrates how diverse these definitions of diagnostic criteria are, since the intersection of definitions is very poor, resulting in only 9.2% affected individuals.

Diagnostic Criteria of the Metabolic Syndrome

Due to different diagnostic criteria there was a high demand for an internationally standardized recommendation. At present, the joint statement of Alberti et al. 2009 is the most accepted recommendation in the field, whereat three of five risk factors constitute a diagnosis:

Waist CircumferencePopulation and country­‐specific definition
Elevated Triglycerides> 150 mg/dL (1.7 mmol/L)
Reduced HDL-CFemale < 50 mg/dL (1.3 mmol/L)
Male < 40 mg/dL (1.0 mmol/L)
Elevated Blood PressureSystolic > 130 and/or
Diastolic > 85 mm Hg*
Elevated Fasting Glucose> 100 mg/dL

*Hypertension is defined as systolic ≥ 140 mm Hg and diastolic ≥ 90 mm Hg