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Cited by 84Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and ResearchAdipokines, Inflammation, and Metabolic Diseases

The Metabolic Syndrome (Emperor) Wears No Clothes

Kahn, Richard·2006·Diabetes Care
DOI 10.2337/dc06-0671
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Abstract

There are several key features of the metabolic syndrome that virtually all interested individuals and organizations agree upon. First, that certain “metabolic” factors tend to associate with each other more often than chance would dictate. Second, these risk factors taken alone or in any possible combination are associated with an elevated risk for cardiovascular disease (CVD) and diabetes. Third, there is no definitive treatment for the “syndrome” per se. Rather, therapy is individualized according to the degree to which any specific risk factor(s) is present in a patient, and everyone with any risk factor(s) should be given lifestyle modification counseling. Finally, despite over 10,000 articles on the subject, there is much missing information. It is this last fact that has lead to the concern and consternation voiced by some organizations (1) and individuals (2–6). That is, the basic question is whether we know enough about this constellation of risk factors to warrant adopting a unique clinical construct that has value to either physicians or patients. After all, the fundamental purpose of a medical label (diagnosis) is to inform physicians and/or patients to take (or not take) action that would otherwise be different. In this issue of Diabetes Care (7) and recently elsewhere (8), Scott Grundy, MD, PhD, perhaps the chief proponent of the syndrome as a clinical construct, defends its existence with a variety of arguments. Although he suggests the basic disagreement is one of “differences in perspectives and biases [between the] cardiovascular and diabetes communities” (7) and that it may boil down to “how to integrate the metabolic syndrome into concepts of insulin resistance, pre-diabetes, and type 2 diabetes” (8), in fact, the issues are much more fundamental, speak to the lack of a solid evidence base, and raise concerns that are critical to a core premise …

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  • The term Metabolic Syndrome remains the most widely accepted name to describe the cluster of metabolically related CVD risk factors despite attempts to discard it as a clinical entity.

    “The term Metabolic Syndrome remains the most widely accepted name to describe this cluster of metabolically related CVD risk factors 40 despite vigorous attempts to discard the syndrome as a clinical entity 43, 53.”

    From The Circadian Syndrome: is the Metabolic Syndrome and much more! (2019) · cites this paper as [53]

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Authors
Kahn, R.
Affiliations
American Diabetes Association (US)
Corresponding author
Kahn, Richard
ORCID
Kahn, Richard
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2006-07-01
Volume
29
Issue
7
Pages
1693-1696
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc06-0671
OpenAlex
W2166715351
Cited by
84
References
32
Citations by year
2021: 1 · 2019: 2 · 2018: 1 · 2017: 2 · 2016: 3 · 2014: 1 · 2012: 5
FWCI
11.75
Type
journal article
Language
en
Open access
closed
Locations
Diabetes Care (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Keywords
metabolic syndrome, cardiovascular risk, type 2 diabetes, insulin resistance, prediabetes, diagnosis, risk factor clustering, lifestyle modification, evidence base

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