Distressful journey for the metabolic syndrome to its position in clinical practice


Authors: J. Rybka
Authors‘ workplace: Diabetologické centrum Interní kliniky IPVZ Krajské nemocnice T. Bati, a. s., Zlín, přednosta doc. MUDr. Čestmír Číhalík, CSc.
Published in: Vnitř Lék 2010; 56(7): 727-735
Category: 80th Birthday - Jaroslava Blahoše, MD, DrSc.

Overview

MS is a major atherogenic syndrome in our population. The concept of MS has had a very positive effect on our knowledge of the most serious civilization diseases, the genotypic constellation of MS, although monogenic defects explain only a very small part of pathological defects. It is certain, however, that a crucial role played is by interactions between genetic factors and risk factors of external environment. Undoubtedly, insulin resistance, central obesity and impaired metabolism of adipose tissue play an important role in the pathogenesis of MS, and there are other pathogenetic theories. The author discusses briefly the history of MS and presents the best‑known definitions starting with the 90s of the last century, ADA and EASD reservations towards MS, as well as the new harmonized definition from 2009. This modified definition of MS has been adopted in practice in the Czech Republic due to the Czech Institute of metabolic syndrome. The author discusses in greater detail the WHO expert report from 2010, which indicates some limitations of diagnostic criteria for MS. Despite all the objections the expert report provides reasons to support the use of the term metabolic syndrome, and metabolic syndrome is considered to be a recognized concept that focuses attention on the importance of comprehensive, multifactorial health problems. Finally, the author mentions sub‑problems related to MS, which will have to be resolved in collaboration with diabetologists.

Key words:
metabolic syndrome – history of MS – evolutionary perspective – insulin resistance – definitions – WHO expert consultation report on MS – prediabetes and MS


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