Thursday, February 28, 2008

The New Hub-Bub Over Metabolic Syndrome

Metabolic Syndrome has long been identified as a risk factor for heart disease. However, idientifying exactly what it is and what its cause or causes are has been a subject of much debate. Now, a new study published in Cell Metabolism has thrown the issue into a full-fledged brouhaha over whether Metabolic Syndrome is a multi-cause condition or more simply a single cause condition with multiple symptoms. For example, is small-LDL a contributor to a diagnosis of Metabolic Syndrome or is some other single root cause driving a host of symptoms such as small-LDL to appear.

The Multi-Cause camp has labored long and hard at defining what group of causes is sufficient to render a diagnosis of Metabolic Syndrome. Different organizations have different standards but all require having some combination of common symptoms such as:

Here are links to the various guidelines NCEP ATP III (what most U.S. doctors use), American Heart Association, World Health Organization (pages 32 and 33), European Group on Insulin Resistance (EGIR).

This latest study by the Joslin Diabetes Center focuses on insulin resistance in the liver as the key factor in the cause of metabolic syndrome and its association with heart disease. It advances the theory that metabolic syndrome is not simply a collection of abnormalities that should be treated independently but a group of closely linked disturbances in glucose and cholesterol metabolism that stem from a defect in insulin signaling in the liver. This thinking suggests the cure for Metabolic Syndrome is not to treat a variety of symptoms but rather to find and treat the underlying cause perhaps with a single "magic bullet." This is tantatmount to treating and eliminating a cold virus rather than treating the associated symptoms aches, sore thoat, congestions, and sniffles associated with the cold.

OK, great! Now let's find that magic bullet!



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