【medical-news】代谢综合征 皇帝的新衣？
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http://www.medscape.com/viewarticle/562090
The Metabolic Syndrome: Does It Exist?
The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD), in a joint position statement, question the existence of the metabolic syndrome.[1] They claimed it is a new medical condition when, in fact, it was described in the 1920s by Kylin, a Swedish physician.[2] This aggregation of cardiovascular risk factors is frequently observed in clinical practice. In addition, the cluster of risk factors that make up the syndrome fits the dictionary definition of a syndrome.
The majority of the diabetes and the cardiovascular community are strongly united in the view that this clustering of closely related risk factors for cardiovascular disease and type 2 diabetes is an excellent basis for calling this a syndrome. A syndrome is simply a cluster with no implications regarding etiology. It is, by definition, a set of symptoms or conditions that occur together and suggest the presence of a disease or an increased chance of developing the disease.
A major issue is whether the metabolic syndrome is a valid indicator of cardiovascular risk. I would have to agree with the ADA and the EASD on this point. However, they misunderstand the intentions of the International Diabetes Federation (IDF) definition[2] and the National Cholesterol Education Program (NCEP) Expert Panel ATP III[3] definition for the metabolic syndrome. It is not meant to be a risk assessment tool for short-term, 10-year risk. The latter is best achieved by global risk algorithms, such as that provided by the Framingham Heart Study. From a scientific and academic perspective, there are better algorithms, such as Framingham. However, from a clinical perspective, the metabolic syndrome serves a useful purpose to focus on people, in both the community and clinical settings, who are at high risk of developing cardiovascular disease and type 2 diabetes, particularly using the ATP III and the IDF criteria.
That's my opinion. I'm Professor Paul Zimmet, Director of the International Diabetes Institute in Melbourne, Australia.
The Metabolic Syndrome: Does It Exist?
The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD), in a joint position statement, question the existence of the metabolic syndrome.[1] They claimed it is a new medical condition when, in fact, it was described in the 1920s by Kylin, a Swedish physician.[2] This aggregation of cardiovascular risk factors is frequently observed in clinical practice. In addition, the cluster of risk factors that make up the syndrome fits the dictionary definition of a syndrome.
The majority of the diabetes and the cardiovascular community are strongly united in the view that this clustering of closely related risk factors for cardiovascular disease and type 2 diabetes is an excellent basis for calling this a syndrome. A syndrome is simply a cluster with no implications regarding etiology. It is, by definition, a set of symptoms or conditions that occur together and suggest the presence of a disease or an increased chance of developing the disease.
A major issue is whether the metabolic syndrome is a valid indicator of cardiovascular risk. I would have to agree with the ADA and the EASD on this point. However, they misunderstand the intentions of the International Diabetes Federation (IDF) definition[2] and the National Cholesterol Education Program (NCEP) Expert Panel ATP III[3] definition for the metabolic syndrome. It is not meant to be a risk assessment tool for short-term, 10-year risk. The latter is best achieved by global risk algorithms, such as that provided by the Framingham Heart Study. From a scientific and academic perspective, there are better algorithms, such as Framingham. However, from a clinical perspective, the metabolic syndrome serves a useful purpose to focus on people, in both the community and clinical settings, who are at high risk of developing cardiovascular disease and type 2 diabetes, particularly using the ATP III and the IDF criteria.
That's my opinion. I'm Professor Paul Zimmet, Director of the International Diabetes Institute in Melbourne, Australia.
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