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Insulin Resistance and the Metabolic Syndrome

Principles of Diabetes Mellitus

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Abstract

In 1988 Gerald Reaven’s Banting Lecture popularized the metabolic syndrome and proposed that insulin resistance was the underlying etiology of a set of abnormalities including glucose intolerance, hypertension, and a distinct lipid profile of high triglyceride and low HDL cholesterol level with resultant increased cardiovascular disease and diabetes. This physiological concept evolved into an epidemiological one used to predict cardiovascular disease and diabetes. Following multiple definitions by self-appointed organizations, in 2009 an international group of experts proposed a “harmonized” definition of the metabolic syndrome. This definition included a population-specific measure of waist circumference, elevated plasma triglyceride, low plasma HDL cholesterol, hypertension, and elevated blood glucose. The metabolic syndrome has been tested in numerous large, longitudinal population studies to determine its ability to predict cardiovascular disease above and beyond its individual components.

The evidence is mixed and suggests that metabolic syndrome does not uniquely predict incident CV disease or mortality over and above its components. Despite positive reports, overall, the metabolic syndrome is a rather poor predictor of CV disease in type 2 diabetes.

The metabolic syndrome is likely to be not more than the sum of its parts after adjusting for standard CV risk factors. Although it is a good predictor of diabetes, it is not as good as the fasting plasma glucose.

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  1. SUNY Downstate Medical Center, New York, NY, USA

    Mary Ann Banerji & Milay Luis Lam

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    Leonid Poretsky

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Banerji, M.A., Lam, M.L. (2016). Insulin Resistance and the Metabolic Syndrome. In: Poretsky, L. (eds) Principles of Diabetes Mellitus. Springer, Cham. https://doi.org/10.1007/978-3-319-20797-1_34-1

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    Insulin Resistance and the Metabolic Syndrome
    Published:
    10 February 2017

    DOI: https://doi.org/10.1007/978-3-319-20797-1_34-2

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    Insulin Resistance and the Metabolic Syndrome
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    DOI: https://doi.org/10.1007/978-3-319-20797-1_34-1

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