Pathogenesis of the metabolic syndrome

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Resistance to the action of insulin is a central feature of the metabolic syndrome. Liver, skeletal muscle and adipose tissue are considered the major insulin-responsive tissues but the vasculature also can be considered as an insulin-responsive organ. In the metabolic syndrome insulin resistance is linked predominantly to a cluster of disorders involving triglyceride and glucose metabolism, increased blood pressure and vascular inflammation. Although to date there is no central unifying mechanism that explains all of the features of the syndrome, it is most likely that certain of the features occur as secondary consequences of a primary abnormality (or several primary abnormalities). Given that insulin resistance is fundamental to a diagnosis of the

Table 1.3 Estimated prevalence and number of people 20+ years of age with the metabolic syndrome and diabetes by region for 2000 (see text for details of methods)

Region Population Prevalence of the metabolic syndrome (%) Number with the metabolic Diabetes (Wild

(thousands) syndrome (thousands) etal., 2004)

Table 1.3 Estimated prevalence and number of people 20+ years of age with the metabolic syndrome and diabetes by region for 2000 (see text for details of methods)

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