Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: Dr Unwin is concerned that grouping
individuals together under the category of the metabolic syndrome may lead
to a loss of predictive information. We found these individuals not only have
a 2- to 3-fold higher cardiovascular mortality, but also a 5- to 9-fold increased
risk of developing diabetes.1 We hope that
future studies will determine whether the recognition, treatment, and ultimately
prevention of the metabolic syndrome as defined by the NCEP or the WHO will
improve the prognosis of these individuals. Our own clinical experience suggests
that most persons with the metabolic syndrome but without manifest cardiovascular
disease or diabetes go unrecognized and untreated, because the abnormalities
are usually mild in and of themselves. Focusing on individual or conventional
risk factors only will leave most of these individuals undertreated or untreated.
Lakka H, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT. Definitions of the Metabolic Syndrome. JAMA. 2003;289(10):1240-1241. doi:10.1001/jama.289.10.1240-a