ABSTRACT
Metabolic syndrome (MetS) is the name given to a group of risk factors that increase an individual’s risk of CHD and other related problems including diabetes and stroke. Th ese include: abdominal adiposity (as defi ned by a large WHR); a higher than normal triglyceride level; a lower than normal level of high density lipoprotein cholesterol (HDL-cholesterol); a higher than normal blood pressure; and a higher than normal fasting glucose level or insulin resistance. While the World Health Organization and the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) have slightly diff erent cut-off values and diagnostic criteria (Haff ner 2007), in principle a diagnosis of MetS is made when three or more of the fi ve previously listed factors are present. Individuals with MetS have an aggressive form of vascular disease that is characterized by accelerated atherosclerosis and pro-infl ammatory changes (Haff ner 2007). Th e exact pathophysiology of MetS is unknown but is thought to be mediated through insulin resistance and visceral obesity. Men with MetS, but not diabetes, have a twofold increased CVD risk, which is increased to threefold in the presence of diabetes. Th is increased risk in the presence of diabetes is even more apparent in women. In the absence of diabetes, women with MetS have a twofold greater risk of CVD than women without MetS but in the presence of diabetes this risk increases dramatically to eightfold (Haff ner 2007), highlighting the therapeutic importance of addressing gender-specifi c multiple risk factors. Th e relationship between WHR and adhesion molecules has been previously examined and in the following section the relationship between adhesion molecule levels and the other risk factors for MetS will be examined before looking at the eff ect of combinations of these factors.
