viernes, 28 de septiembre de 2018

History of Metabolic Syndrome

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By Ananya Mandal, MDReviewed by Sally Robertson, BSc

The risk factors associated with diabetes were observed as early on as the 1920s, but the term “metabolic syndrome” was only coined in the 1950s and then became commonly used in the 1970s.

In 1947, the French physician Jean Vague noticed that upper body obesity seemed to be associated with an increased risk for the conditions atherosclerosis, diabetes, kidney stones and gout. Avogaro, Crepaldi and colleagues then reported how six obese patients demonstrated improvements in their diabetes, high blood cholesterol and high triglycerides when they followed a low-calorie and low-carbohydrate diet.

The term “metabolic syndrome” was used in 1977 by Herman Haller who was studying the risk factors associated with atherosclerosis. He used the term in reference to the associations between obesity, diabetes mellitus, high blood lipids, a high uric acid level (predisposes to gout) and fatty liver disease (hepatic steatosis) and how the combined presence of these factors increase the risk of atherosclerosis developing. In the same year, Singer used the term to describe the associations between hyperlipoprotenemia and obesity, gout, diabetes mellitus, and hypertension.

The next year, Gerald Phillips introduced the concept that a combination of risk factors exist for myocardial infarction that not only predispose to heart disease, but are also associated with an increased risk for obesity and other clinical states. He described the presence of these risk factors as a “constellation of abnormalities” and they included glucose intolerance, hyperinsulinemia and a high level of triglycerides, glucose, cholesterol and insulin. Phillips hypothesized that one underlying factor could be linked to the combined presence of these risk factors that if identified, could be researched to help prevent cardiovascular disease. He suggested that this common factor could involve the sex hormones.

In 1988, Gerald Reaven hypothesized that insulin resistance could be the underlying factor linking this constellation of abnormalities, which he went on to name “syndrome X.”