THE METABOLIC

SYNDROME

EPIDEMIOLOGY, CLINICAL
TREATMENT, AND UNDERLYING
MECHANISMS

The metabolic syndrome can be considered as a clustering of several risk factors,
including hypertension, dyslipidemia, impaired glucose tolerance, and central adiposity.

The recognition of this clustering has evolved over almost 90 years. According to Pan-
teleimon Sarafidis' and Peter Nilsson's historical account ofthe origins ofthe metabolic

syndrome, during World War I, two Austrian physicians, Karl Hitzenberger and Martin
Richter-Quittner, identified a link between hypertension and diabetes (1). Furthermore,
they identify Eskil Kylin and Gregorio Maranon, respectively a Swede and a Spaniard,
who published similar findings in this period (1). Another discovery that Sarafidis and
Nilsson refer to is H.P. Himsworth's distinguishing between insulin-resistant and

insulin-sensitive diabetics in 1936-suggesting a common pathophysiological back-
ground linking metabolic risk factors (1). During the 1940s,