Summary

• A cluster of common abnormalities, including insulin resistance, impaired glucose tolerance, abdominal obesity, reduced HDL-cholesterol levels, elevated triglycerides, and hypertension.
• Incidence is increasing in line with the number of people who are overweight or obese, with one quarter of the Western population estimated to have the condition.
• Multiple criteria exist to define metabolic syndrome.
• Increases risk of cardiovascular disease and diabetes, although there are ethnic variations in the incidence of comorbidities associated with metabolic syndrome defined by the same criteria.
• The precise pathogenetic mechanisms unifying all of its components are as yet unknown, although insulin resistance certainly plays a key role.
• Obesity, an atherogenic diet, and physical inactivity are the strongest risk factors for the development of metabolic syndrome.
• Lifestyle interventions, including a diet low in saturated fats and moderate to intense physical activity, are the mainstay of treatment.
• A multifactorial approach targeting LDL-cholesterol and non-HDL-cholesterol levels, BP control, and glucose reduction is recommended.
• Statins are considered first-line treatment when lifestyle measures do not achieve the desired non-HDL-cholesterol levels. Fibrates also play a significant role in the modification of lipid levels.