Metabolic
syndrome
is
a
multiplex
risk
factor
that
____________________
from
insulin
resistance
accompanying
abnormal
adipose
deposition
and
____________________
.
It
is
a
risk
factor
for
coronary
heart
____________________
,
as
well
as
diabetes
,
fatty
liver
,
and
several
____________________
.
The
clinical
manifestations
of
this
syndrome
may
include
____________________
,
hyperglycemia
,
hypertriglyceridemia
,
reduced
high
-
density
lipoprotein
cholesterol
(
HDL
-
C
)
,
and
____________________
obesity
.
(
See
Prognosis
,
Workup
,
Treatment
,
and
Medication
.
)
Under
current
guidelines
,
revised
in
2005
by
the
National
Heart
,
Lung
,
and
Blood
Institute
(
NHLBI
)
and
the
American
Heart
Association
(
AHA
)
,
metabolic
syndrome
is
diagnosed
when
a
patient
has
at
least
3
of
the
following
5
conditions
(
see
Presentation
and
Workup
)
:
Fasting
glucose
?
100
mg
/
dL
(
or
receiving
drug
therapy
for
hyperglycemia
)
Blood
pressure
?
130
/
85
mm
Hg
(
or
receiving
drug
therapy
for
hypertension
)
Triglycerides
?
150
mg
/
dL
(
or
receiving
drug
therapy
for
hypertriglyceridemia
)
HDL
-
C
<
40
mg
/
dL
in
men
or
30
kg
/
m2
in
lieu
of
the
waist
circumference
criterion
.
)
To
address
variation
____________________
professional
guidelines
,
the
National
Heart
,
Lung
,
and
Blood
Institute
(
NHLBI
)
,
American
Hearth
Association
(
AHA
)
,
International
Diabetes
Foundation
(
IDF
)
,
and
other
organizations
have
proposed
a
harmonized
definition
of
metabolic
syndrome
.
Abundant
data
suggest
that
patients
meeting
these
diagnostic
____________________
have
a
greater
risk
of
significant
clinical
consequences
,
the
2
most
prominent
of
which
are
the
development
of
diabetes
____________________
and
of
coronary
heart
disease
.
Pooled
data
from
37
____________________
involving
more
than
170
,
000
patients
have
shown
that
metabolic
____________________
doubles
the
risk
of
coronary
artery
disease
.
It
____________________
increases
risk
of
stroke
,
fatty
liver
disease
,
and
____________________
.
Controversy
The
clinical
value
of
the
recognition
of
____________________
syndrome
as
a
distinct
entity
has
been
challenged
.
One
____________________
questioned
the
predictive
value
of
the
metabolic
syndrome
____________________
for
the
development
of
diabetes
and
cardiovascular
events
____________________
older
populations
(
aged
70
-
82
y
and
60
-
79
y
)
.
Neither
population
showed
a
relationship
between
____________________
outcomes
and
3
of
the
metabolic
syndrome
criteria
(
for
waist
circumference
,
triglycerides
,
and
glucose
)
.
Moreover
,
____________________
this
group
of
older
patients
,
the
diagnosis
of
____________________
syndrome
was
not
more
predictive
of
incident
diabetes
____________________
was
the
fasting
plasma
glucose
level
alone
.
Clearly
,
the
individual
clinical
features
that
make
up
the
syndrome
____________________
predictive
of
clinical
outcomes
,
but
whether
grouping
these
____________________
together
under
____________________
umbrella
of
metabolic
syndrome
adds
____________________
diagnostic
,
therapeutic
,
and
prognostic
value
remains
the
subject
____________________
ongoing
debate
.