The dysmetabolic syndrome

The first unifying definition for the metabolic syndrome was proposed by WH O in 1998. In accordance to this, patients with type 2 diabetes mellitus or impaired glucose tolerane have the syndrome if they fulfil two of the crit eria: hypertension, dyslipidaemia. obesity/abdominal obesity and microalbum inuria. Persons with normal glucose tolerance (NGT) should also be insulin resistant. About 40% of persons with impaired glucose tolerance (IGT) and 7 0% of patients with type 2 diabetes have features of the syndrome. Importan tly, presence of the dysmetabolic syndrome is associated with reduced survi val, particularly because of increased cardiovascular mortality. The dysmet abolic syndrome most likely results from interplay between several genes an d an affluent environment. Compatible with the thrifty gene theory, common variants in genes regulating lipolysis, thermogenesis and glucose uptake in skeletal muscle account for a large part of such thrift-v genes. However, hitherto unknown genes may still be identified by random gene approaches.