Description

Metabolic syndrome is a disorder of energy utilization and storage, diagnosed by a co-occurrence of three out of five of the following medical conditions: abdominal (central) obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and low high-density lipoprotein (HDL) levels. Noncommunicable diseases, which include diabetes mellitus and cardiovascular diseases, are the world's biggest killer diseases, estimated to cause 3.5 million deaths each year. Eighty percent of them are found in the low- and middle-income countries. The WHO has developed an action plan for implementation of global strategies in prevention and control of noncommunicable diseases.1 One of the objectives of this plan is to develop simple strategies to identify those at risks, together with appropriate and cost-effective interventions.

Metabolic syndrome has been advocated as a simple clinical tool for predicting diabetes mellitus and cardiovascular diseases. It also forms a conceptual base for understanding some of the pathophysiological links between metabolic risks, diabetes mellitus, and cardiovascular disease (CVD). The clustering of metabolic syndrome risks with cardiovascular disease and diabetes mellitus has been recognized for more than 80 years, but the modern concept of metabolic syndrome began when Reaven proposed a conceptual framework that links biological events in a single pathophysiological construct.2 Reaven construct suggested that insulin resistance provides common mechanisms underlying the associated abnormalities such as blood pressure, lipid abnormalities, and glucose intolerance. In 1947, Vague, a physician from Marseilles, observed that upper body obesity was significantly associated with diabetes mellitus, atherosclerosis, gout, and calculi; and all these conditions were improved by eating a low-carbohydrate diet.3-4 Haller in 1977 described metabolic syndrome to be associated with obesity.