Metabolic Syndrome (MetS)

The clinical cluster of hypertension, cardiovascular disease, hyperlipemia, hyperuricemia and type 2 Diabetes had been recognized by physicians for many decades, described as syndrome X and finally metabolic syndrome (MetS). A few decades ago, investigators noted this syndrome in the alarming pandemic of obesity and type 2 diabetes. Different definitions of metabolic syndrome had been developed by the World Health Organization (WHO), the National Cholesterol Education Program me Adult Treatment Panel 111 (NCEP-ATP111) and by the International Diabetes Federation (IDF). High Triglycerides, low HDL-C, hypertension, raised fasting plasma glucose, and central obesity are essential factors. Obligatory factors such as obesity (BMI ≥ 30) and high waist circumference with ethnic specificity were required by WHO and IDF criteria respectively. Cutoff points of systolic and diastolic blood pressures, HDL-C and fasting plasma glucose of WHO criteria were required to be adjusted; and cutoff points of waist circumference for males and females of IDF were required to be standardized with European and non-European populations, South Asians and South-East Asians of WHO and IDF criteria. Later, three out of five criteria was introduced by NCEP ATP111 instead of obligatory requirements plus two out of four criteria used by WHO and IDF. To be practical for application to public health sectors, MetS has been defined by at least two criteria such as hypertriglyceridemia-waist and hypertensive-waist by validation to IDF criteria definition. Some elements of MetS are noted to be clustered more frequently in some ethnic populations. Individuals without type 2 DM, obesity or MetS are noted to have low HDL-C regardless of age in some populations, probably based on genetic susceptibility. Gender also has an impact on HDL-C level, lower in females than males in general. Then, triglycerides and total cholesterol levels increase with age.