ABSTRACT

Recently, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) issued a joint statement urging caution on accepting a universal definition of the metabolic syndrome (10). Their thesis is based principally on the perceived lack of precision in the cut points of the various components of the syndrome. While there is a certain superficial validity in this claim, one has to temper these apparent shortcomings with the findings of other studies such as the Interheart study, which established the universality of the conventional cardiovascular risk factors in identifying those likely to develop a myocardial infarction (MI) (11). In this study, although the cut points were not defined with the level of precision demanded by the ADA and the EASD, the risks attached to some of the variables, which constitute the metabolic syndrome, were identified clearly. While scientific rigor requires that definitions of diseases should be as precise as possible, demands for an impossible level of precision in identifying the metabolic syndrome carry the risk of relegating what is an important public health issue to the status of the 800-lb somnolent simian in the room, whose lethality becomes apparent only when it awakes.