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Etiology of the Metabolic Syndrome—Reply
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In Reply: Dr Miller questions whether the term "metabolic syndrome" is appropriate for the clustering of risk factors that are commonly associated with obesity and insulin resistance. The metabolic syndrome is a multidimensional risk factor consisting of 5 metabolic risk factors, including atherogenic dyslipidemia, elevated blood pressure, glucose intolerance, a prothrombotic state, and a proinflammatory state. The root causes of the syndrome appear to be multiple and include obesity (especially abdominal obesity), physical inactivity, insulin resistance, aging, and genetics.1-3
The National Cholesterol Education Program Adult Treatment Panel III4 chose the term "metabolic syndrome" to include in its cholesterol guidelines for several reasons. First, metabolic syndrome is the name widely used by both cardiovascular and diabetes communities, and is the one most frequently cited in the literature. Second, it identifies the clustering of risk factors as being metabolic in origin without specifically identifying their underlying causes. Evidence is currently insufficient to . . . [Full Text of this Article]
Scott M. Grundy, MD, PhD
Departments of Clinical Nutrition, Internal Medicine, and the Center for Human Nutrition
University of Texas Southwestern Medical Center
Dallas
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