The fundamental questions raised by Kahn et al. are 1) whether the wellestablished clustering of metabolic risk factors underlying both CVD and type 2 diabetes deserve to be called a "syndrome" and, 2) even if the metabolic syndrome can be accepted as a concept, whether the concept has matured enough to be introduced into medical practice. The first is a matter of semantics and is controversial because of differences in perspectives and biases of cardiovascular and diabetes communities and individual investigators. Yet the term metabolic syndrome seems to be as good for describing the proven clustering of metabolic risk factors as any alternative. The second question is more substantial and requires considerations of the growing importance of obesity in causation of CVD and diabetes, the need for more intensive lifestyle intervention in clinical risk management, and the necessity for identification of patients in whom multiple risk factors convey greater risk than otherwise recognized by a single-risk factor strategy for CVD and diabetes prevention. There appears to be growing support for moving clinical practice away from the single-risk factor strategy to one that focuses on multiple risk factors, of which the metabolic syndrome is a prime example.
ASJC Scopus subject areas
- Internal Medicine
- Endocrinology, Diabetes and Metabolism
- Advanced and Specialized Nursing