Predicting CVD/IHD Mortality: Framingham Risk Score vs. Metabolic Syndrome

摘要

The metabolic syndrome (MetS), initially called Syndrome X by Reaven in 1988(1), has become the most popular risk engine for cardiovascular disease since the Framingham Risk Score (FRS) was developed in 1998(2). The MetS cluster of risk factors has been accepted internationally, albeit under several different names and with modifications in the criteria. It has been the subject of more than 20,524 publications (according to Pub Med listings). There is now a Metabolic Syndrome journal and a Metabolic Syndrome annual meeting. The reason for the widespread enthusiasm for MetS is not entirely clear, but may reflect: 1. its ease of use (each risk factor gets a score of one, and the math, i.e., number of components, rarely goes higher than six); 2. its attention to obesity and particularly to central obesity (curiously omitted by Framingham and even from the original Syndrome); and 3. the centrality of insulin resistance in the Syndrome X hypothesis, suggesting a mechanism for the link between diabetes and heart disease.