Metabolic Syndrome: Assessing Cardiometabolic Risk

The metabolic syndrome refers to a constellation of coronary heart disease risk factors, including obesity and abdominal fat distribution, disorders of glucose and lipid metabolism, and hypertension. Among the traditional risk factors, diabetes, hypertension, and abdominal obesity together account for approximately half of the risk of a first myocardial infarction, esp. in the Asian Indian population. ‘Cardiometabolic risk’ is a new entity that goes beyond metabolic syndrome to encompass a cluster of risk factors that may predispose individuals to CVD and type 2 diabetes mellitus. These risk factors, some of which are currently undermanaged in clinical practice, involve multiple pathways and physiological systems, and point to a need for a comprehensive management approach. Cardiometabolic risk factors tend to cluster. Assessment of the full spectrum of cardiometabolic risk must be done in every patient who has even one or two clinically evident risk factors. The latest trials show that tackling insulin resistance with thiozoladinediones is showing promise in patients with metabolic syndrome. Successful management of cardiometabolic risks depends on the physician’s ability to identify all appropriate risk factors, as well as on the development of more comprehensive management options.