As DrRich reported a few weeks ago, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) recently released a remarkable statement questioning the existence of "metabolic syndrome," and discouraging doctors from using this terminology. ( Read about metabolic syndrome here.) Searching for some scientific rationale for this statement and finding none, DrRich speculated that the diabetes associations were acting primarily to protect their turf. With the cardiology community's recent emphasis on metabolic syndrome, diabetes specialists may have seen cardiac doctors as encroaching on territory that, by rights, ought to belong to them.
Now, as if to vindicate the (what some might call paranoid) speculations of your humble reporter, the American Heart Association and the National Heart, Lung and Blood Institute (NHLBI) have released a major new statement on the importance of metabolic syndrome, published in the September 12 issue of Circulation. This new statement adjusts the criteria for diagnosing metabolic syndrome slightly (mainly in light of new guidelines for treating cholesterol.) But its main point is to reemphasize the importance of metabolic syndrome and its treatment.
People who have at least 3 of the following 5 conditions are said to have metabolic syndrome:
- Elevated waist circumference (abdominal obesity).
- Elevated triglycerides.
- Reduced HDL cholesterol.
- Elevated blood pressure.
- Elevated fasting glucose.
Metabolic syndrome is seen in 26% of American adults. Those with metabolic syndrome have up to 3 times the usual risk of developing significant cardiovascular disease, and up to a 5-fold risk of developing overt diabetes.
The bottom line is this: Let the political wings of the diabetes associations and cardiology associations fight about what to call it. The fact is, whatever you call it, both diabetes specialists and cardiac specialists agree on the essential point - aggressive therapy of all the abnormal risk factors associated with this syndrome ought to be employed. Failing to do so invites an extraordinarily high risk of heart attack, stroke, and diabetes.
