What men should know about metabolic syndrome, adiposopathy and ‘sick fat’

The term 'metabolic syndrome' (MetSyn) is a term created to identify common atherosclerotic cardiovascular disease (CVD) risk factors that often cluster together (1). MetSyn was never intended to describe an underlying pathophysiological process. Other challenges with MetSyn include that: (i) multiple definitions exist for the same syndrome; (ii) multiple other terms describe same or similar syndrome and (iii) the diagnosis of MetSyn may not provide any better prediction of future disease than an assessment of its individual risk factors (2―4). From a clinical management standpoint, the term 'metabolic syndrome' may not be a particularly instructive or effective term in patient education (5). In contrast, since the 1940s (6), the data support visceral adiposity as an example of a unified, pathophysiological contributor to the abnormalities associated with MetSyn, such as high glucose levels, high blood pressure, high triglyceride levels, reduced high density lipoprotein cholesterol levels and increased CVD risk (7).