Reaven's original description of the metabolic syndrome consisted of obesity, insulin resistance, hypertension, impaired glucose tolerance or diabetes, hyper-insulinemia, and dyslipidemia characterized by elevated triglyceride and low HDL concentrations.1 All these features serve as risk factors for atherosclerosis and thus metabolic syndrome constitutes a significant risk for coronary heart disease2-5 (Table 2.1). The features of obesity or overweight and insulin resistance also provide significant risks for developing type 2 diabetes.5,6 The risks for CHD and diabetes with metabolic syndrome are greater than those for simple obesity alone without insulin resistance and therefore the understanding of the pathogen-esis and, through it, a rational approach to its therapy are of prime importance.
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