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"Metabolic syndrome": an artificial construct
that does not improve treatment

The diagnosis of "metabolic syndrome", whose definition varies from one source to another, is of no use when it comes to improving patients' treatment. It is better to tackle each component of the "syndrome": obesity, diabetes, arterial hypertension and lipid disorders.

A concept dubbed "metabolic syndrome" has been much written about, especially in recent years. The definition of "metabolic syndrome" lumps together a number of disorders that are more or less related, including obesity, lipid disorders (dyslipidaemia), impaired glucose metabolism (particularly type 2 diabetes) and high blood pressure. There are several lists of criteria to help diagnose metabolic syndrome, but they contain important divergences, which only underlines the artificial nature of this syndrome.

In practice, there is no point in diagnosing "metabolic syndrome" since there is no specific, clinically proven treatment. In practice, it is better to treat each disorder definitely known to be associated with an increased occurrence of cardiovascular disorders, and for which there is a treatment with a proven track-record in reducing the morbidity and mortality rate, and a positive benefit-harm balance.

Some isolated "metabolic syndrome" factors are best treated by a fitness and dietary regime, while others require drug treatment (diabetes for example).

©Prescrire July 2006

Source: "Le syndrome métabolique : une construction artificielle inutile aux soins" Rev Prescrire 2006 ; 26 (273) : 444-447.

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