September 15, 2005 – Does Metabolic Syndrome, Also Known As Syndrome X, Really Exist? American and European researchers doubt it.
Metabolic syndrome refers to several factors – from 11 to 16, depending on the lists consulted – which, in combination, would indicate an individual’s risk of suffering from cardiovascular disease. These factors include, for example, excess abdominal fat, high blood pressure, insulin resistance or glucose intolerance.
The existence of this syndrome is recognized by organizations as prestigious as the World Health Organization and the American Heart Association. But, in the September edition of the publications Diabetes Care and Diabetologia, the European Association for the Study of Diabetes (AEED) and the American Diabetes Association (ADA) say that, from a scientific point of view, there is no justification for the importance given to it by the medical community.
As an example, the AEED and the ADA cite the divergent definitions put forward by different organizations. They also underline the contradictory results obtained by studies which have sought to measure the link between the metabolic syndrome and cardiovascular disease.
According to an ADA spokesperson, Dr Richard Kahn, the term “metabolic syndrome” gives patients the impression that they are suffering from a specific disease, when in fact they only have well-known risk factors for cardiovascular disease and diabetes.
Dr Paul Lépine, employee of PasseportSanté.net, considers that this news is in line with a movement that questions what a disease is. “The pharmaceutical industry keeps inventing new diseases or redefining the ‘normal’ to sell more pills. I am sympathetic to the idea that the metabolic syndrome is a collection of things already known rather than a disease, ”he explains.
For her part, the president of the AEED, Dr Ele Ferrannini, explains that the combination of several factors does not increase the risk of suffering from cardiovascular disease and that each factor should be treated individually without seeking to group them arbitrarily.
On this, Dr. Lépine expresses some reservations. “It’s a position that can be defended, but with which I’m less comfortable,” he continues. It goes against the logic of integrated medicine. You have to see the person as a whole. What happens, for example, if physical exercise alleviates all of the risk factors for Syndrome X? “
ADA and AEED believe that doctors should not diagnose metabolic syndrome, much less try to treat it, until science defines it better. Rather, they encourage them to consider other risk factors for cardiovascular disorders.
As for Dr Lepine, he advocates caution: “It should not be concluded that what is called the metabolic syndrome is unimportant.”
Jean-Benoît Legault – PasseportSanté.net
According to Reuters and Prevention.
1. Kahn R, Buse J, Ferrannini E, Stern M. The Metabolic Syndrome: Time for a Critical Appraisal. Diabetes Care, September 2005, Vol. 28, No 9, 2289-2304. To access the summary as well as the full text: http://care.diabetesjournals.org/cgi/content/abstract/28/9/2289 [site consulté le 7 septembre 2005].
