The Metabolic Syndrome

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In 1979, Kannel and McGee [4] discovered increased incidence of cardiovascular disease in patients with diabetes. Almost a decade later, Reaven [5] described the metabolic syndrome as consisting of three or more of the fol-

V. Stocchi (ed), Role of Physical Exercise in Preventing Disease and Improving the Quality of Life ©Springer 2007

lowing criteria; central obesity, atherogenic dyslipidemia, raised blood pressure, insulin resistance or glucose intolerance, prothrombotic state, and proin-flammatory state. According to the International Diabetes Foundation (http://www.idf.org) the new consensus worldwide definition of the metabolic syndrome, for persons to be defined as having the metabolic syndrome they must be centrally obese and have any two of the following four factors: raised triglyceride level, reduced HDL cholesterol, raised blood pressure, raised fasting plasma glucose, or previously diagnosed type 2 diabetes. The metabolic syndrome is now present in at least 25% of the US population, according to updated statistics from the American Heart Association (http://www.americanheart.org). The metabolic syndrome is a multifactorial disease caused by interactions between multiple genetic and environmental factors, and several studies link impaired aerobic metabolism to the patho-genesisof the metabolic syndrome in humans [6,7].A limitation in studies indicating a cause-effect relationship between the metabolic syndrome and aerobic metabolism in humans is that one cannot exclude the possibility that the observed impairment in metabolism may be caused by other health behaviors not measured. An animal model therefore seems to be the preferable model to test whether there is a cause-effect relationship between impaired aerobic capacity and occurrence of the metabolic syndrome. As such, an introduction to aerobic capacity and metabolism is warranted, including a summarized presentation of the cardiovascular system as to how it may determine aerobic capacity.

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