The Metabolic Syndrome: An Adult Disease that Begins in Childhood

摘要

In adults, the aggregation of multiple cardiovascular risknfactors was observed in the early part of the twentiethncentury. More recently, however, similar clusteringnhas received renewed attention and several terms such asnsyndrome X,1 insulin resistance syndrome,2 and metabolicnsyndrome3 have been proposed to describe the connectionnbetween obesity, insulin resistance, hypertension, dyslipidemia,ntype 2 diabetes mellitus, and atherosclerotic cardiovascularndisease. Despite this well-known association in adults,nthe definition of metabolic syndrome varies in terms of thenindicators that are used and the cut-points that are requirednto make the diagnosis.4-6 The most common criteria werenproposed by The Third Report of The National CholesterolnEducation Program Expert Panel on Detection, Evaluation,nand Treatment of High Blood Cholesterol in Adults (thenAdult Treatment Panel III or ATP III)5 and those criterianfrom the World Health Organization (WHO)6 are most commonlynused in adults. Two of these common definitions4,6ninclude measures of insulin resistance. This inclusion reflectsnthe proposed causal role of insulin and its interaction in thendevelopment of the metabolic syndrome in adults