Groups affirm utility of metabolic syndrome dx.

Less than a month after two major diabetes organizations called metabolic syndrome a poorly defined and misleading diagnosis, the American Heart Association and the National Heart, Lung, and Blood Institute issued a joint statement reaffirming that the syndrome is valid and clinically useful.

The new AHA/NHLBI scientific statement basically confirms the recommendations on diagnosis and management of metabolic syndrome that were issued in 2001 as part of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) report.

The statement also clarifies some issues and provides some minor modifications to the ATP III definition of the metabolic syndrome--a term that denotes the clustering of interrelated metabolic risk factors for atherosclerotic cardiovascular disease.

Compared with the joint statement published last month by the American Diabetes Association and the European Association for the Study of Diabetes ("Groups Wary to Use Term 'Metabolic Syndrome.'" OB.GYN. NEWS, Sept. 15, p. 18), the AHA/NHLBI statement offers a clearly different perspective on the meaning and value of a term that's now commonplace in the medical literature.

"Metabolic syndrome is a valuable clinical tool. Physicians must pay attention to it, and they must give enough attention to lifestyle (intervention)," said Scott M. Grundy, M.D., director of the Center for Human Nutrition at the University of Texas Southwestern Medical Center in Dallas. Dr. Grundy chaired the panel that wrote the joint statement.

While the diabetes organizations questioned the value of the syndrome as a predictor of cardiovascular disease--they said, for instance, that it's "uncertain" whether it's a useful marker of cardiovascular disease risk "above and beyond the risks associated with its individual components"--the AHA/NHLBI panel maintained that it's an important and useful predictor.

The absolute short-term (10-year) risk for major coronary heart disease events is not necessarily high--and may be best assessed by Framingham risk scoring. The longer-term risk associated with the syndrome is "undoubtedly" elevated, regardless of the Framingham score, the panel said (Circulation ...