Some defend metabolic syndrome's clinical value

While the search is under way to find solid evidence of the syndrome's predictive power, many clinicians ask: Why not use it in the meantime?

By Susan J. Landers, AMNews staff. Nov. 7, 2005.

Washington -- A debate over the usefulness of the constellation of conditions known as metabolic syndrome in predicting disease shows no sign of abating.

The American Assn. of Clinical Endocrinologists and the American College of Endocrinology released a statement Oct. 14 reaffirming their belief that the syndrome, which they call insulin-resistance syndrome, remains a clinically useful tool.

Questions concerning the syndrome's value were raised in late August by the American Diabetes Assn. and its European counterpart, triggering an investigation by the endocrinologists into the science behind a decision they made two years earlier to publish a definition of the syndrome.

They determined that the science was solid. "There is nothing we said then that is not correct," said Yehuda Handelsman, MD, a co-chair of the AACE panel that drafted the initial statement and a member of the team from AACE/ACE that reviewed it.

The debate raises the question of what to do about the 47 million Americans who are overweight, have hypertension and high triglyceride and fasting glucose levels. Many physicians believe that this cluster of risk factors, known as metabolic syndrome, is particularly important in predicting which patients will develop diabetes or cardiovascular disease.

Metabolic syndrome is also credited by many with getting patients to pay heed to the importance of weight loss and increased physical activity in maintaining health.