Metabolic syndrome

Last revised by Daniel J Bell on 3 Nov 2021

The metabolic syndrome, also known as syndrome X, is a set of five conditions, which together increase a patient's risk of developing cardiovascular disease 1.

Clinical presentation

There are five central components of metabolic syndrome:

  1. hyperinsulinaemia
  2. impaired glucose tolerance
  3. dyslipidaemia
  4. hypertension
  5. centripetal obesity

It has been recognised for more than thirty years that the key metabolic phenomenon underlying the five elements of the metabolic syndrome is the development of insulin resistance 1.

Diagnosis

The clinical diagnosis of metabolic syndrome relies upon measuring central adiposity, glucose tolerance, blood pressure, and serum lipid levels.

History and etymology

The interconnectedness of these five entities was recognised decades ago, but the term metabolic syndrome was not coined until 1988 by American endocrinologist, Gerald M Reaven (1928-2018) 3 in the annual Banting lecture 2. Reaven was revered as the “father of insulin resistance”, for his groundbreaking research in this area 3.

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