In this paper, a WHO Expert Consultation reported their view on the usefulness of the metabolic syndrome as a concept and clinical tool. The critics argued the criteria used to diagnose the metabolic syndrome such as the dichotomisation of risk factors, the differing predictive value of risk factor combinations, the omission of established risk factors and the attribution of relative risk as opposed to absolute risk. The WHO experts concluded that it had limited practical utility as a diagnostic or disease management tool and should not be ranked as a clinical diagnosis. They emphasized that metabolic syndrome is a pre-morbid condition rather than a clinical diagnosis. In addition, they recommended that each country should develop cost-effective, context-specific diabetes and cardiovascular disease risk identification and prevention strategies. In their comment, Borch-Johnsen K and Wareham N endorsed the recommendations of the WHO experts and they even suggested putting the concept of metabolic syndrome to rest.
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