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Review: Challenges in developing therapies for the metabolic syndrome

Division of Endocrinology and Diabetes, Department of Medicine, New York University School of Medicine, New York, USA, glennmatfin{at}hotmail.com

Metabolic syndrome refers to a clustering of cardiovascular (CV) risk factors within a single individual. The established risk factor such as obesity, type 2 diabetes, dyslipidaemia, hypertension, and other emerging risk factors are closely related to intra-abdominal adiposity. Insulin resistance is also considered to be an important factor in the aetiology of this syndrome. The emerging risk factors include dysfunction of inflammation, coagulation, platelets, fibrinolysis, lipoproteins, endothelium, and other biological processes. Despite the potential utility of having all the CV risk factors under one umbrella term, debate continues about the very existence of the metabolic syndrome and its diagnostic criteria. Nevertheless, the component risk factors include some of the most common and serious public health challenges facing the developed and developing world today. By treating component risk factors, many existing therapies and new drugs in development target several aspects of metabolic syndrome. However, no drug is currently approved specifically for treatment of the metabolic syndrome.

The essential features of the metabolic syndrome, and some of the challenges in developing treatment options are discussed herein.

Key Words: diabetes • metabolic syndrome • obesity.

References

• Eckel R., Grundy S., Zimmet P. Metabolic syndrome. Lancet 2005;365: 1415-28.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Fonseca V. Risk factors for coronary heart disease in diabetes. Ann Intern Med 2000;133:154-6.[Free Full Text]
• Lawlor DA, Lean M., Sattar N. ABC of obesity: Obesity and vascular disease. BMJ 2006;333:1060-3.[Free Full Text]
• Reaven GM Role of insulin resistance in humans. Diabetes 1988;37: 1595-607.[Abstract]
• Kahn R. Buse J., Ferrannini E. et al. The metabolic syndrome: Time for a critical appraisal. Diabetes Care 2005;28:2289-304.[Abstract/Free Full Text]
• Alberti KG, Zimmet P. The metabolic syndrome: time to reflect. Curr Diabetes Rep 2006;6:259-61.[CrossRef]
• Hossain P., Kawar B., El Nahas M. Obesity and diabetes in the developing world - agrowing challenge. N Engl J Med 2007;356:213-15.[Free Full Text]
• Flordellis CS, Ilias I., Papavassiliou AG New therapeutic options for the metabolic syndrome. Trends Endocrinol Metab 2005;16:254-60.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Food and Drug Administration: Guidance for Industry Developing Products for Weight Management. Available at: http://www.fda.gov/cder/guidance/7544dft.pdf(Accessed February 2007).
• Grundy S., Cleeman J., Daniels S. et al. Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-52.[Free Full Text]
• Alberti KG, Zimmet P., Shaw J. The metabolic syndrome - a new worldwide definition. Lancet 2005;366:1059-60.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Kershaw EE, Flier JS Adipose tissue as an endocrine organ. J Clin Endo Metab 2004;89:2548-56.[Abstract/Free Full Text]
• Goldstein BJ, Scalia R. Adiponectin: a novel adipokine linking adipocyte and vascular function. J Clin Endo Metab 2004;89:2563-8.[Abstract/Free Full Text]
• Hug C., Lodish HF Visfatin: a new adipokine. Science 2005;307:366-7.[Abstract/Free Full Text]
• Ford ES Prevalence of the metabolic syndrome by the International Diabetes Federation among adults in the US. Diabetes Care 2005;28:2745-9.[Abstract/Free Full Text]
• DECODE study group. Comparison of different definitions of the metabolic syndrome in relation to cardiovascular mortality in European men and women. Diabetologia 2006;49:2837-46.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Tushuizen ME, Diamant M., Heine RJ Postprandial dysmetabolism and cardiovascular disease in type 2 diabetes. Postgrad Med 2005;81:1-6.[Abstract/Free Full Text]
• Ryden L., Standl E., Bartnik M. et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. Europ Heart J 2007;28:88-136.[Free Full Text]
• Ridker PM Clinical application of C-reactive protein for cardiovascular disease detection and prevention. Circulation 2003;107:363-9.[Free Full Text]
• Van Gaal LF, Rissanen AM, Scheen AJ et al. Effects of the cannabinoid-1 receptor blocker rimonabant on weight reduction and cardiovascular risk factors in overweight patients: 1-year experience from the RIO-Europe study. Lancet 2005;365:1389-97.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Wald NJ, Law MR A strategy to reduce cardiovascular disease by more than 80%. BMJ 2003;326:1419.[Abstract/Free Full Text]
• Reddy KS The prevention polypill- much promise, insufficient evidence. N Engl J Med 2007;356:212.[Free Full Text]

The British Journal of Diabetes & Vascular Disease, Vol. 7, No. 4, 152-156 (2007)
DOI: 10.1177/14746514070070040301


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This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Matfin, G. Search for Related Content Social Bookmarking                         What's this?