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March 12, 2003

Definitions of the Metabolic SyndromeDefinitions of the Metabolic Syndrome

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(10):1240-1241. doi:10.1001/jama.289.10.1240-a

To the Editor: In their study of the metabolic syndrome and mortality, Dr Lakka and colleagues1 did not assess sleep-disordered breathing (sleep apnea). Obesity, the central feature of the metabolic syndrome, is also the greatest risk factor for obstructive sleep apnea (OSA), which associated with cardiovascular disease in a dose-dependent way.24 The severity of sleep-disordered breathing also correlates with many other risk factors for cardiovascular disease, including markers of oxidative stress and of inflammation, such as adhesion molecules, interleukin 6, and C-reactive protein.5,6 More convincing, however, is the evidence that treatment of OSA, in the absence of weight loss or other treatment for metabolic syndrome, reduces blood pressure7 and cardiovascular risk.4

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