Insulin resistance, obesity and the metabolic syndrome.

The metabolic syndrome is a clinically important but often misunderstood topic. A concept in evolution, controversy surrounds the metabolic syndrome. The medical literature documents disagreement in the criteria for diagnosis, a shift in emphasis as to the roles of obesity and insulin resistance as underlying causes, and questions about the fundamental clinical utility of the syndrome. The practical strengths and limitations of the metabolic syndrome in clinical practice are reviewed.