Istv�n Wittmann
Second Department of Medicine, University of P�cs, Medical Faculty, P�cs, Hungary

Introduction

Combination of metabolic abnormalities in patients with high vascular risk is well known since long time. In his Banting lecture Reaven used the term �Syndrome X� for the description of the coexistence of these metabolic diseases. Other names as e.g. �Deadly Quartet� and insulin resistance syndrome emphasised the consequences and the possible cause of this syndrome. Most of the authors accept that the syndrome in the patients induces serious complications and that in its background insulin resistance could be the major determinant.

Nevertheless, recently the existence of metabolic syndrome was questioned and an independent treatment of the components of the metabolic syndrome was suggested. Nowadays, in this �post metabolic syndrome� period newest papers are examining new and old questions, whether metabolic syndrome exists, what are the important components, is diabetes mellitus a component or a final result of the syndrome, which definition describes better the essence of the syndrome, which definition predicts the mortality, which components are better predictors for cardiovascular morbidity and mortality, etc. However, a relatively new estimation formula for insulin resistance using homeostasis model assessment (HOME) made possible to study the role of insulin resistance in big cohorts.

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