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In Reply: Dr Unwin is concerned that grouping individuals together under the category of the metabolic syndrome may lead to a loss of predictive information. We found these individuals not only have a 2- to 3-fold higher cardiovascular mortality, but also a 5- to 9-fold increased risk of developing diabetes.¹ We hope that future studies will determine whether the recognition, treatment, and ultimately prevention of the metabolic syndrome as defined by the NCEP or the WHO will improve the prognosis of these individuals. Our own clinical experience suggests that most persons with the metabolic syndrome but without manifest cardiovascular disease or diabetes go unrecognized and untreated, because the abnormalities are usually mild in and of themselves. Focusing on individual or conventional risk factors only will leave most of these individuals undertreated or untreated.

Factor analysis has frequently generated different lists of lipid or blood pressure variables that comprise the metabolic . . . [Full Text of this Article]

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