Is Metabolic Syndrome the Main Threat to Human Health in the Twenty-First Century?
Series Editor: Marja-Riitta Taskinen
See page 2276
Solid evidence has confirmed that the Metabolic Syndrome is associated with an increased risk of both type 2 diabetes and cardiovascular disease (CVD). Recognizing the full blown global epidemics of type 2 diabetes and obesity, the prevalence of the metabolic syndrome is rapidly growing and portends a daunting wave of CVD—a threat to human health in this century. Metabolic syndrome is a cluster of cardiometabolic risk factors that coexist in obese and insulin-resistant people. Although there has been a debate on the criteria and concept of the metabolic syndrome, the current definition by the National Cholesterol Education Program–Adult Treatment Panel (NCEP-ATP III) and the International Diabetes Federation (IDF) provide adequate screening tools to identify the subjects with high cardiometabolic risk. With these tools in hand the stage is set for attempts to discover the pathophysiology underlying these metabolic abnormalities. Over past years evidence has emerged that inflamed adipose tissue, excess visceral fat, and insulin resistance are the critical elements that contribute to the features of the metabolic syndrome. This review series aims to highlight the consequences and causes of dysfunctional adipose tissue and the ectopic accumulation of fat on atherogenesis and CVD risk factors. The identification of intracellular signaling elements and regulating factors at crossroad steps that direct the metabolic fate of lipids are critical for the understanding of atherogenic dyslipidemia in the metabolic syndrome. Importantly, several lipid metabolites seem to play a crucial role in the regulation of insulin signaling and action influencing endothelial function and initiating vascular injury. The concept that dysfunctional adipose tissue cannot properly handle the energy surplus derived from excessive calorie consumption combined with sedentary lifestyle sets the stage to identify the main determinants of the metabolic syndrome in different populations. Resolving these issues is crucial for the optimal management of the metabolic syndrome and reduction of global CVD risk. This review series will provide snapshots on the elements considered to be important for the conceptual understanding of the metabolic syndrome, its impact on CVD, and treatment in clinical practice.