This review paper by Després et al. provides a brief outline of the story behind the concept of the metabolic syndrome developed after the pioneering work of Dr. Reaven. The paper examines screening tools proposed by various organizations, the debate around the metabolic syndrome, and the importance of making the distinction between the definition of the metabolic syndrome versus the clinical tools used to identify individuals likely to have it. The paper presents the advantages and limitations of clinical diagnosis of the metabolic syndrome. Evidence that intra-abdominal (visceral) obesity is the most prevalent form of the metabolic syndrome is also reviewed, and the definition of global cardiometabolic risk, which encompasses the risk attributable to the metabolic syndrome and to the contribution of traditional risk factors, is illustrated. The paper recommends targeting high-risk intra-abdominal obesity in order to properly manage patients at high global cardiometabolic risk. The preferred way to reach this objective is the adoption of healthy lifestyle habits.
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