As part of the brief reviews series on the metabolic syndrome and atherosclerosis published in Arteriosclerosis, Thrombosis and Vascular Biology, Després et al. suggested that abdominal obesity was the most frequently observed form of the metabolic syndrome in clinical practice. They also proposed a pathway that could link genetic and environmental determinants to intra-abdominal obesity, an altered adipokine secretion pattern, and insulin resistance, which in turn favour the development of the metabolic syndrome. They mentioned that although the metabolic syndrome is an important cardiovascular disease (CVD) risk factor, it should not replace the evaluation of traditional CVD risk factors. Because elevated waist circumference is often associated with several cardiometabolic abnormalities, even in the presence of a “normal” body mass index, Després et al. suggested that measuring both waist circumference and triglyceride levels, the so-called hypertriglyceridemic waist, could provide an easy and inexpensive clinical tool to identify patients with excess intra-abdominal/ectopic fat and related risk. Finally, they proposed that clinical diagnosis of the metabolic syndrome along with the assessment of traditional CVD risk factors could provide a better estimate of global CVD risk, defined as global cardiometabolic risk.
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