Metabolic syndrome under fire: weighing in on the truth.

In the past two decades, the 'metabolic syndrome' has raised much clinical and research interest and remains a controversial topic. The constellation of commonly coexisting cardiovascular risk factors, now known as the metabolic syndrome, has had many definitions which has added to the confusion surrounding the syndrome. Recently, the controversy has been escalated by a joint statement from the American Diabetes Association and the European Association for the Study of Diabetes calling into question the existence and clinical utility of the metabolic syndrome as a discrete clinical entity. Despite the controversy, there is agreement that the risk factors of abdominal obesity, hypertension, elevated glucose and dyslipidemia commonly coexist in the same patient, and are important to identify when assessing an individual patient's risk. Therefore, whether the 'syndrome' is a distinct clinical entity is not important. By definition, a syndrome is a group of signs or symptoms that commonly group together. It remains a useful clinical tool to raise awareness among health care professionals to look for 'nontraditional' cardiovascular risk factors, such as glucose intolerance or elevated waist circumference, in patients with other components of the syndrome, without negating the importance of identifying and treating the other 'traditional' risk factors not identified in the syndrome. It also reminds clinicians of the importance of lifestyle interventions to treat all of the components of the syndrome. Therefore, the 'metabolic syndrome' continues to serve a useful clinical purpose to raise awareness among health care professionals and aid in identifying high-risk individuals.