The metabolic syndrome: definitions, prevalence and management.

The metabolic syndrome (MetS) refers to the clustering of various metabolic risk factors that include abdominal obesity, dyslipidemia, hypertension, and hyperglycemia. It is now well known that it is associated with an increased risk of cardiovascular disease (CVD) and of type 2 diabetes. The increasing prevalence of the MetS, associated with the substantial progression of obesity and diabetes, is therefore an important public health concern. Over the years, several definitions for the MetS have been proposed by major scientific associations. Those definitions differ somewhat in their criteria and threshold values but generally all agree on the essential components of the syndrome. The proposed definitions are intended to help identify individuals at increased long-term risk of CVD, who could benefit from early prevention. The diagnosis of the MetS should be used concurrently with standard predicting algorithms, such as the Framingham Risk Score and the Diabetes Predicting Model, which better predict short-term risks. The management of the MetS should emphasize therapeutic lifestyle modifications--weight loss, increased physical activity, healthy diet--as the first-line therapy. If the short-term risk of CVD or diabetes is high, specific risk factors should be monitored more closely according to established guidelines and drug therapy may be appropriate.