Metabolic syndrome: multiple candidate genes, multiple environmental factors--multiple syndromes?

Key elements of the metabolic syndrome include the development of insulin resistance, glucose intolerance, dyslipidaemia and hypertension, which lead to multiple effects on lipoprotein metabolism and vascular functions and, ultimately an increased risk of cardiovascular disease. There are probably multiple presentations of the metabolic syndrome, and these depend on the interplay of genetic variation and environmental factors. In particular, polymorphisms in genes that are expressed in adipose tissue may play a crucial role in the development of the metabolic syndrome. Elucidation of the aetiology of metabolic syndrome(s) will therefore play an important role in developing strategies to reduce adverse outcome. It is probable that pharmacological therapy will be needed for many patients with the metabolic syndrome to help reduce the risk of future cardiovascular events.