Multifactorial intervention in metabolic syndrome targeting at prevention of chronic kidney disease ready for prime time?

The term metabolic syndrome (MetSyn) indicates a constellation of risk factors associated with increased burden of atherosclerotic disease [1]. Despite some controversy regarding its existence as a distinct entity [2], accumulating evidence suggests that individuals with MetSyn are at increased risk of cardiovascular events and type 2 diabetes [3,4]. Several factors such as obesity, insulin resistance, physical inactivity and advancing age seem to constitute its pathophysiological basis [1,5]. The prevalence of MetSyn depends on the studied population and the definition used but in Western populations more than 20% of adults are affected [6]. Current ‘popular’ definitions of MetSyn, such as that of the National Cholesterol Education Program Adult Treatment Panel (NCEP ATP) III, the National Heart, Lung, and Blood Institute and the American Heart Association (NHLBI/AHA) and especially that proposed by the International Diabetes Federation (IDF) (Table 1) are continuously evaluated as to whether they can identify high-risk population for cardiovascular disease and diabetes who would benefit from intensive behavioural and/or pharmacological treatment [7,8].