Syndrome X – a term, coined by Gerald Reaven (1988), describes a cluster or a group of symptoms (abnormalities) including high blood pressure, abdominal obesity, insulin resistance, glucose intolerance and dyslipidemia- elevated blood triglycerides and bad cholesterol (LDL), and decreased levels of good cholesterol (HDL). In 1988, at the end of his Banting Memorial lecture (in Stanford University) Reaven claims: “At first blush it appears outlandish to suggest an association between hypertension, hypertriglyceridemia and hyperinsulinemia.”
The terms ‘metabolic syndrome,’ ‘insulin resistance syndrome’ (IRS), ‘dysmetabolic syndrome,’ ‘Syndrome X,’ ‘Raven’s syndrome,’ ‘plurimetabolic syndrome,’ ‘hypertriglyceridemia waist syndrome’ ‘visceral fat syndrome,’ ‘cardiometabolic syndrome,’ ‘general cardiovascular syndrome,’ and CHAOS (in Australia) are synonyms defining a cluster of conditions (abnormalities) that occur together in a person, increasing his risk for development of type 2 diabetes, atherosclerotic vascular disease (AVD), coronary artery disease (CAD), stroke, etc.
Metabolic syndrome is also named the “Deadly Quartet” (1989) by Norman Kaplan, MD (professor of internal medicine at the University of Texas) as it can include upper-body obesity, glucose intolerance, hypertriglyceridemia, and hypertension. Kaplan believes that underlying the “Deadly Quartet” is the excessive blood-insulin levels often associated with insulin resistance.(Women’sHeartAdvantage)
Gale (2002) identifies the acronym CHAOS as an abbreviation for coronary artery disease, hypertension, atherosclerosis, obesity, and stroke. Actually, the metabolic syndrome is a cluster of disorders, affected by genetics, diet, and other environmental and lifestyle (intrinsic and extrinsic) factors (Grundy et al., 2005).
Five metabolic risk factors (dyslipidemia, hyperglycemia, hypertonia, general prothrombotic state with proinflammatory state) are blamed for its appearance and above all, they are all commonly clustered together. (Source, HealthStatus) As the cluster of abnormalities is frequently observed in allopathic clinical practice, it has been well documented in prospective studies by several cluster-analytical trials (Grundy, 2007; Hanley et al., 2002). Experimental evidence suggests that it is the exact nature of the cluster which appears to bring additional risk, over and above the one that would be expected from each one of the components seen separately. Stern et al. (2004) conclude that people with metabolic syndrome have five fold greater risk of developing Type 2 diabetes, if not already presenting with this disorder.
There are statistic expectations that up to 80% of the almost 200 million adults worldwide will die of CVD, according to the International Diabetes Federation (IDF, 2003). Hence, people suffering from metabolic syndrome are also at increased risk of mortality, as they are three times as likely to die from stroke or heart attack, and twice as likely to die from a coronary event, compared to people without metabolic syndrome. More than 300 million worldwide are now classified as obese, according to the World Health Organization (WHO, 2009), while another billion of people are considered overweight. The European health report (EHR, 2005) places metabolic syndrome far ahead of HIV/AIDS in morbidity and mortality.
Jean-Pierre Després, PhD, FAHA (director of the lipid research center at Laval University Hospital in St. Foy, Quebec) claims, “Syndrome X is the most important public health problem in North America. Having this syndrome is as high a cardiovascular risk as having high cholesterol, yet most of the people who have it have normal or close-to-normal cholesterol they think they’re fine.” Finally, the syndrome has been identified as an actual disease state with the code ICD9. “Nothing helped metabolic syndrome more than the establishment of the ICD9 code.” – Yehuda Handelsman, MD (co-chair of the International Committee for Insulin Resistance and medical director of the Metabolic Institute of America).
Joanna Breitstein (2004) states,” The science is beginning to understand the role of insulin resistance,” and proceeds, “A new disease is being born. Unlike a new pathogen bursting from the jungle like Ebola or mutating from something familiar like each year’s “new” strain of influenza, metabolic syndrome must be both socially and scientifically constructed. Well-known medical facts have been reorganized into a new understanding. And with that knowledge comes the need and opportunity for new research, new modalities of treatment, and, on the pharma side, new market risks, demands, and opportunities.” The author’s final prediction is that “by 2025y – 86 million Americans will have the metabolic syndrome.”
Some of the clinical syndromes and diseases, following the metabolic syndrome appearance are: (a) type 2 diabetes mellitus; (b) cardiovascular disease (CVD); (c) essential hypertension; (d) polycystic ovary syndrome (PCOS); (e) nonalcoholic fatty liver disease; (f) certain forms of cancer; (g) sleep apnea; (h) gout; (i) kidney failure, and (j) Alzheimer’s disease (Annual Rev. Nutr. 2005).
The American College of Cardiology (ACC) and the American Diabetes Association (ADA) recently launched “Make the Link,” campaign informing physicians and consumers that people with metabolic syndrome are undeniably linked to type 2 diabetes what can increase risk of heart disease and stroke. At the same time a new society called the “International Society of Diabetes and Vascular Research” launched its own journal-“Diabetes & Vascular Disease Research” (May, 2004)
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