What was changed in interpretation, diagnosis and patogeny of the metabolic syndrome in the last twentyfive years?

Written by Kun Imre Zoltán, Szántó Zsuzsanna

This review is a survey of the modifications occurred in the last 25 years regarding the interpretation, diagnosis and pathogenesis of metabolic syndrome (MS). Although this syndrome was observed already from the beginning of the last century, Reaven introduced this as a novel clinical entity in 1988 and made an attempt to find causal relationships between its components. He considered the insulin resistance and the subsequent hyperinsulinism as the basic pathogenetic factors, trying to explain on this base the other components of the syndrome.This hypothesis was contested by many authors, but its importance can not be negated, being sustained by facts. Nowadays MS is interpreted in its complexity. The intense and diversified researches made possible to obtain more and more profound knowledges concerning this syndrome, so now the ectopic, visceral adipose tissue became a very important pathogenetic factor, emphasizing the role of adipokines (CRP, TNF-a, IL-6) and that of other mediators and hormones. The accumulation of theoretical knowledges resulted a continuous evolution of diagnostic criteria: the international organisations and scientific societies published between 1998-2005 eight diagnostical systems, but with significant differences, making difficult a common diagnosis. During many years dominated the WHO-system elaborated in 1999 and the American NCEP/ATP-III-system created in 2001, and only thereafter was generally accepted the diagnostical criteria of International Diabetes Federation (IDF), processed in 2005 and perfected by the Harmonizing the Metabolic Syndrome Conference in 2009, what is considered the actual base of interpretation and diagnosis of MS.


Keywords: changes in interpretation, diagnosis and patogeny of metabolic syndrome, last twentyfive years

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