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Canadian Journal of Cardiology

Metabolic Syndrome Sinkholes: What to Do When Occam's Razor Gets Blunted

  • Ross D. Feldman
    Correspondence
    Corresponding author: Dr Ross D. Feldman, Departments of Medicine and Physiology & Pharmacology, Schulich School of Medicine & Dentistry, University of Western Ontario Robarts Research Institute, 1151 Richmond St N, London, Ontario N6A 5B7, Canada. Tel.: +1-519-931-5717; fax: +1-519-931-5222.
    Affiliations
    Robarts Research Institute, London, Ontario, Canada

    Department of Medicine, Western University, London, Ontario, Canada

    Department of Physiology & Pharmacology, Western University London, Ontario, Canada
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  • Todd J. Anderson
    Affiliations
    Libin Cardiovascular Institute and the Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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  • Rhian M. Touyz
    Affiliations
    Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
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      Abstract

      The real promise of the metabolic syndrome concept was the opportunity to elucidate a singular common mechanism for its component abnormalities and consequently a singular therapy. That promise has not produced. This relates to the following considerations: (1) metabolic syndrome remains a syndrome not a disease, (2) its diagnosis offers little more than what can be determined by measuring waist circumference, (3) risk assessment is not improved by the diagnosis of metabolic syndrome, (4) the diagnosis of metabolic syndrome does not impact the treatment of each component of the syndrome, and (5) there is no effective therapy for metabolic syndrome in its entirety.

      Résumé

      La véritable promesse du concept de syndrome métabolique était la possibilité d’élucider le mécanisme commun particulier des anomalies de ses composantes et par conséquent mettre au point un traitement particulier. Cette promesse ne s’est pas concrétisée. Cela est fondé sur les considérations suivantes : 1) le syndrome métabolique est bien un syndrome, et non une maladie; 2) son diagnostic offre un peu plus que ce que la mesure du tour de taille permet de déterminer; 3) le diagnostic du syndrome métabolique n’améliore pas l’évaluation du risque; 4) le diagnostic du syndrome métabolique n’a pas de répercussion sur le traitement de chacune des composantes du syndrome; 5) aucun traitement efficace n’existe pour traiter globalement le syndrome métabolique.
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