Metabolic syndrome: no internationally defined standard cut-off value for waist circumference

The metabolic syndrome (MS) is a cluster of interre-lated risk factors of metabolic origin - metabolic risk factors that appear to directly promote the development of ath-erosclerotic cardiovascular disease and increase the risk of development of type 2 diabetes.1 In addition to diabetes, these patients with MS have increased incidence of elevated plasma triglycerides, lower high density lipoproteins (HDL), and higher blood pressure. The association with MS has now been expanded to include small dense, low density lipoprotein (LDL), abdominal/truncal obesity, prothrombotic states with increased levels of plasminogen activator in-hibitor type 1 (PAI-1), microalbuminuria, impaired fasting glucose (insulin resistance syndrome) and proinflammatory states. Although there is no agreement on a universal defi-nition of MS, insulin resistance, impaired fasting glucose or diabetes constitute major criteria for this definition.