The underlying cause(s) of the metabolic syndrome are not fully understood. Intra-abdominal (visceral) obesity and insulin resistance are thought to be the driving forces behind the development of the metabolic syndrome.
Although the metabolic syndrome is associated with incident CVD and diabetes, it is not clear whether it enhances CVD and diabetes risk on top of currently available algorithms for assessing CVD and diabetes risk.
Further research and work is needed to eventually harmonize metabolic syndrome diagnosis criteria and develop new modelling approaches to take into account the linear relationship between the features of the metabolic syndrome and CVD and diabetes risk.
For the moment, it is unclear whether the metabolic syndrome is a clinical entity that increases CVD and diabetes risk more than the sum of its individual components. It is also unclear whether the metabolic syndrome should be treated differently than its individual components.
Evaluation of the association between the first observation and the longitudinal change in C-reactive protein, and all-cause mortality. Heart 2008;94:457-62