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Critics question usefulness of metabolic syndrome diagnosis

Some say the syndrome is no more than the sum of its parts, while others cite its value as a predictor for diabetes and heart disease.

By Susan J. Landers, amednews staff. Sept. 19, 2005.

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Washington -- Has metabolic syndrome become a misleading diagnosis or a helpful tool?

A debate is under way over the benefit to patients of clustering a number of risk factors for diabetes and heart disease into this specifically named constellation of symptoms.

An opening volley in this dispute included charges that the syndrome is poorly defined, inconsistently used and in need of further research. It was fired by the American Diabetes Assn. in a joint paper with its European counterpart, the European Assn. for the Study of Diabetes, and published in the September issues of Diabetes Care and Diabetologia.

Now caught in the crossfire are as many as 47 million overweight Americans whose blood pressure, triglycerides and fasting glucose levels are high and whose good cholesterol levels are not sufficient to provide necessary protection against rising rates of diabetes and cardiovascular disease.

The enormity of the public health problem these diseases pose, combined with the syndrome's apparent predictive value for risk, should be reason enough to ensure metabolic syndrome a place in the physician's tool box, say its proponents.

But critics aren't so sure. They stress the need for primary care physicians to pay more heed to the syndrome's individual components rather than be distracted by a grouping of symptoms known by many monikers -- including the more mysterious, syndrome X -- and not supported by solid research.