Metabolic syndrome from the viewpoint of health care medicine *
The Metabolic syndrome is a condition that promotes atherosclerosis and increases cardiovascular risk beyond elevated low-density lipoprotein cholesterol levels. The characteristics of the metabolic syndrome include glucose intolerance, dyslipidemia, hypertension and abdominal obesity. Each abnormality promotes atherosclerosis independently, but when clustered together, the metabolic disorders are increasingly atherogenic and enhance the risk of cardiovascular morbidity and mortality. The definitions proposed by the World Health Organization and the National Cholesterol Education Program have been the most frequently used. Recently, two new criteria for use in clinical practice have been proposed by the International Diabetes Federation and the Japanese communities. Some prospective cohort studies have shown that people with the metabolic syndrome have a higher incidence of cardiovascular disease and all-cause mortality than people without the metabolic syndrome. In this review, we present several types of epidemiological evidence focusing on the association of lifestyle factors such as physical activity, diet and psychological distress with the development of the metabolic syndrome. A few epidemiological studies have reported the significant relationship of the syndrome with lifestyle habits. However, the number of population-based prospective cohort studies is still insufficient. It is important for future studies to consider the association of the metabolic syndrome using newly proposed definitions with cardiovascular and overall mortality. In addition, interventional studies should be conducted to assess what effects an improvement of harmful habits may have on the development of metabolic syndrome.
