The Metabolic Syndrome: 2009

The association of insulin resistance with a clustering of risk factors that not only increased the risk of developing type 2 diabetes mellitus but also contributed to the development of cardiovascular disease was referred to as “syndrome X” by Reaven in 1988 (1). Over the next several years the term “the insulin resistance syndrome” was used to describe these individuals with metabolic abnormalities including atherogenic dyslipidemia, hypertension, abdominal obesity, glucose intolerance, a prothrombotic profile, and a state of increased systemic inflammation. In 1998, the World Health Organization (WHO) task force on diabetes identified insulin resistance as the dominant cause of what we now term the metabolic syndrome and required indicators of insulin resistance to make the diagnosis (2). Over time, the critical role played by abdominal obesity assumed a dominant position in the diagnostic criteria.