Metabolic syndrome and early death.

Metabolic Syndrome and Early Death To the Editor: The editorial by Franks and Olsson1 highlights the heterogeneous nature of definitions of the metabolic syndrome, which results from the number of different combinations of risk factors that equate with a diagnosis of the syndrome. However, the situation is even more complex than indicated in Figure 2 of their editorial. There are, in fact, 16 permutations of components of the metabolic syndrome as defined by the Adult Treatment Panel III definition2: 10 for combinations of 3 metabolic syndrome components, 5 for combinations of 4 metabolic syndrome components, and 1 for the combination of all 5 metabolic syndrome components (Table). The situation is similar for the International Diabetes Federation definition of the metabolic syndrome in which there are 11 possible combinations in people who meet the abdominal obesity criteria.3