MS represents a cluster of strongly associated metabolic variables that each increase the risk for development of CVD and DM. Although IR is closely related to the presence of MS, it is almost certainly not the sole cause. MS itself does not increase the risk of adverse outcomes beyond that predicted by each individual component of the syndrome. Other risk stratification algorithms such as the Framingham Risk Score are better able to predict risk accurately because of inclusion of other emerging CVD risk factors and the use of continuous rather than dichotomous variables. In other words, an HDL-C of 20 is scored differently from an HDL-C of 39. The main clinical utility of MS is recognition by the practitioner that the presence of one or more of the features should provoke an evaluation for the presence of the other components of MS. With respect to treatment, a focus should clearly be placed on interventions that reduce progression of glucose intolerance to DM because DM is a far greater risk factor for CVD than is MS alone. Even modest weight loss in combination with exercise dramatically reduces the risk of progression of IGT to DM. Currently, few definitive data support pharmacologic interventions to increase HDL-C or reduce TG before appropriately reducing plasma LDL levels.
|Title of host publication||Modern Nutrition in Health and Disease|
|Subtitle of host publication||Eleventh Edition|
|Publisher||Wolters Kluwer Health Adis (ESP)|
|Number of pages||9|
|State||Published - Dec 22 2012|