Metabolic syndrome criteria and its association with type 2 diabetes and cardiovascular diseases
Main Article Content
Keywords
Metabolic syndrome, type 2 diabetes, NCEP-ATPIII criteria, IDF, WHO, Risk factors
Abstract
Metabolic syndrome is a cluster of metabolic anomalies such as insulin resistance, obesity, abdominal
fat deposition, hypertension and dyslipidemia, which put an individual at a higher risk of developing
cardiovascular complications. Global variation in ethnicity, culinary habits, availability of nutritious elements,
lifestyle, economic status and disease tolerance/susceptibility of the workforce is reflected in the definition
of the syndrome given by various public health entities. The present review summarizes the recent advances
in the understanding of metabolic syndrome which has been discussed at length by different organizations.
A greater insight into diagnostic criteria of metabolic syndrome will improve our understanding and more
importantly enable the prevention and management of this complex condition.
References
Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet 2005; 365: 1415-28.
2. Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595-607.
3. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002; 287: 356-9.
4. Isomaa B, Almgren P, Tuomi T et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24: 683-9.
5. Yadav D, Mahajan S, Subramanian SK, Bisen PS, Chung CH, Prasad G. Prevalence of metabolic syndrome in type 2 diabetes mellitus using NCEP-ATPIII, IDF and WHO definition and its agreement in Gwalior Chambal region of Central India. Global journal of health science 2013; 5: 142.
6. Trevisan M, Liu J, Bahsas FB, Menotti A. Syndrome X and mortality: a population-based study. Risk Factor and Life Expectancy Research Group. Am J Epidemiol 1998; 148: 958-66.
7. Laaksonen DE, Niskanen L, Nyyssonen K et al. C-reactive protein and the development of the metabolic syndrome and diabetes in middle-aged men. Diabetologia 2004; 47: 1403-10.
8. Srikanthan K, Feyh A, Visweshwar H, Shapiro JI, Sodhi K. Systematic review of metabolic syndrome biomarkers: a panel for early detection, management, and risk stratification in the West Virginian population. International journal of medical sciences 2016; 13: 25.
9. Saltiel AR, Olefsky JM. Inflammatory mechanisms linking obesity and metabolic disease. The Journal of Clinical Investigation 2017; 127: 1-4.
10. Ryliskyte L, Navickas R, Serpytis P et al. Association of aortic stiffness, carotid intima-media thickness and endothelial function with cardiovascular events in metabolic syndrome subjects. Blood Press 2019; 28: 131-8.
11. Lim S, Taskinen MR, Boren J. Crosstalk between nonalcoholic fatty liver disease and cardiometabolic syndrome. Obes Rev 2019; 20: 599-611.
12. Bierman EL. George Lyman Duff Memorial Lecture. Atherogenesis in diabetes. Arterioscler Thromb 1992; 12: 647-56.
13. Lotufo PA, Gaziano JM, Chae CU et al. Diabetes and all-cause and coronary heart disease mortality among US male physicians. Arch Intern Med 2001; 161: 242-7.
14. Hu FB, Manson JE, Stampfer MJ et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med 2001; 345: 790-7.
15. Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB. The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med 2003; 163: 427-36.
16. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998; 15: 539-53.
17. Wang GW, Klein JB, Kang YJ. Metallothionein inhibits doxorubicin-induced mitochondrial cytochrome c release and caspase-3 activation in cardiomyocytes. J Pharmacol Exp Ther 2001; 298: 461-8.
18. Alberti KG, Zimmet P, Shaw J. Metabolic syndrome--a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med 2006; 23: 469-80.
19. Balkau B, Charles MA, Drivsholm T et al. Frequency of the WHO metabolic syndrome in European cohorts, and an alternative definition of an insulin resistance syndrome. Diabetes Metab 2002; 28: 364-76.
20. Einhorn D, Reaven GM, Cobin RH et al. American College of Endocrinology position statement on the insulin resistance syndrome. Endocr Pract 2003; 9: 237-52.
21. Alberti KG, Eckel RH, Grundy SM et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120: 1640-5.
22. Grundy SM, Brewer HB, Jr., Cleeman JI, Smith SC, Jr., Lenfant C. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 2004; 109: 433-8.
23. Ridker PM, Buring JE, Cook NR, Rifai N. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14 719 initially healthy American women. Circulation 2003; 107: 391-7.
24. Grundy SM, Cleeman JI, Daniels SR et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735-52.
25. Grundy SM. Does the metabolic syndrome exist? Diabetes Care 2006; 29: 1689-92; discussion 93-6.
26. Grundy SM. Metabolic syndrome: a multiplex cardiovascular risk factor. J Clin Endocrinol Metab 2007; 92: 399-404.
27. Alberti KG, Zimmet P, Shaw J. The metabolic syndrome--a new worldwide definition. Lancet 2005; 366: 1059-62.
28. Consensus Development Conference on Insulin Resistance. 5-6 November 1997. American Diabetes Association. Diabetes Care 1998; 21: 310-4.
29. Isomaa B. A major health hazard: the metabolic syndrome. Life Sci 2003; 73: 2395-411.
30. Alexander CM, Landsman PB, Teutsch SM, Haffner SM. NCEP-defined metabolic syndrome, diabetes, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes 2003; 52: 1210-4.
31. Wang Q, Chair SY, Wong EM-L, Taylor-Piliae RE, Qiu XCH, Li XM. Metabolic Syndrome Knowledge among Adults with Cardiometabolic Risk Factors: A Cross-Sectional Study. International journal of environmental research and public health 2019; 16: 159.
32. Osei-Yeboah J, Owiredu WK, Norgbe GK et al. The Prevalence of Metabolic Syndrome and Its Components among People with Type 2 Diabetes in the Ho Municipality, Ghana: A Cross-Sectional Study. International journal of chronic diseases 2017; 2017.
33. Klein BE, Klein R, Lee KE. Components of the metabolic syndrome and risk of cardiovascular disease and diabetes in Beaver Dam. Diabetes Care 2002; 25: 1790-4.
34. Shin JA, Lee JH, Lim SY et al. Metabolic syndrome as a predictor of type 2 diabetes, and its clinical interpretations and usefulness. Journal of diabetes investigation 2013; 4: 334-43.
35. Zhang ML, Hou XH, Zhu YX et al. Metabolic disorders increase the risk to incident cardiovascular disease in middle-aged and elderly Chinese. Biomed Environ Sci 2012; 25: 38-45.
36. Kokubo Y, Okamura T, Yoshimasa Y et al. Impact of metabolic syndrome components on the incidence of cardiovascular disease in a general urban Japanese population: the suita study. Hypertens Res 2008; 31: 2027-35.
37. Weiss R, Dziura J, Burgert TS et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004; 350: 2362-74.
38. DuBose KD, Stewart EE, Charbonneau SR, Mayo MS, Donnelly JE. Prevalence of the metabolic syndrome in elementary school children. Acta Paediatr 2006; 95: 1005-11.
39. Morrison JA, Sprecher DL, Barton BA, Waclawiw MA, Daniels SR. Overweight, fat patterning, and cardiovascular disease risk factors in black and white girls: The National Heart, Lung, and Blood Institute Growth and Health Study. J Pediatr 1999; 135: 458-64.
40. Ford ES. Insulin resistance syndrome: the public health challenge. Endocr Pract 2003; 9 Suppl 2: 23-5.
41. Wilson PW, D'Agostino RB, Parise H, Sullivan L, Meigs JB. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation 2005; 112: 3066-72.
42. Brown SA, Hutchinson R, Morrisett J et al. Plasma lipid, lipoprotein cholesterol, and apoprotein distributions in selected US communities. The Atherosclerosis Risk in Communities (ARIC) Study. Arterioscler Thromb 1993; 13: 1139-58.
43. Laws A, Hoen HM, Selby JV, Saad MF, Haffner SM, Howard BV. Differences in insulin suppression of free fatty acid levels by gender and glucose tolerance status. Relation to plasma triglyceride and apolipoprotein B concentrations. Insulin Resistance Atherosclerosis Study (IRAS) Investigators. Arterioscler Thromb Vasc Biol 1997; 17: 64-71.
44. Kekalainen P, Sarlund H, Pyorala K, Laakso M. Hyperinsulinemia cluster predicts the development of type 2 diabetes independently of family history of diabetes. Diabetes Care 1999; 22: 86-92.
45. Hanson RL, Imperatore G, Bennett PH, Knowler WC. Components of the "metabolic syndrome" and incidence of type 2 diabetes. Diabetes 2002; 51: 3120-7.
46. Lorenzo C, Okoloise M, Williams K, Stern MP, Haffner SM. The metabolic syndrome as predictor of type 2 diabetes: the San Antonio heart study. Diabetes Care 2003; 26: 3153-9.
47. Ford ES. Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the U.S. Diabetes Care 2005; 28: 2745-9.
48. Kim SH, Després J-P, Koh KK. Obesity and cardiovascular disease: friend or foe? European heart journal 2015; 37: 3560-8.
49. Lakka HM, Laaksonen DE, Lakka TA et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002; 288: 2709-16.
50. Bonora E, Formentini G, Calcaterra F et al. HOMA-estimated insulin resistance is an independent predictor of cardiovascular disease in type 2 diabetic subjects: prospective data from the Verona Diabetes Complications Study. Diabetes Care 2002; 25: 1135-41.
51. Ninomiya JK, L'Italien G, Criqui MH, Whyte JL, Gamst A, Chen RS. Association of the metabolic syndrome with history of myocardial infarction and stroke in the Third National Health and Nutrition Examination Survey. Circulation 2004; 109: 42-6.
52. Hu G, Qiao Q, Tuomilehto J, Balkau B, Borch-Johnsen K, Pyorala K. Prevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. Arch Intern Med 2004; 164: 1066-76.
53. Campbell B, Aguilar M, Bhuket T, Torres S, Liu B, Wong RJ. Females, Hispanics and older individuals are at greatest risk of developing metabolic syndrome in the US. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2016; 10: 230-3.
54. Kaur J. A comprehensive review on metabolic syndrome. Cardiology research and practice 2014; 2014.
55. Wong ND, Zhao Y, Patel R et al. Cardiovascular risk factor targets and cardiovascular disease event risk in diabetes: a pooling project of the Atherosclerosis Risk in Communities Study, Multi-Ethnic Study of Atherosclerosis, and Jackson Heart Study. Diabetes care 2016; 39: 668-76.
56. Wagh A, Stone NJ. Treatment of metabolic syndrome. Expert Rev Cardiovasc Ther 2004; 2: 213-28.
57. Deedwania PC, Volkova N. Current Treatment Options for the Metabolic Syndrome. Curr Treat Options Cardiovasc Med 2005; 7: 61-74.
58. Rask Larsen J, Dima L, Correll CU, Manu P. The pharmacological management of metabolic syndrome. Expert Rev Clin Pharmacol 2018; 11: 397-410.
2. Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595-607.
3. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002; 287: 356-9.
4. Isomaa B, Almgren P, Tuomi T et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24: 683-9.
5. Yadav D, Mahajan S, Subramanian SK, Bisen PS, Chung CH, Prasad G. Prevalence of metabolic syndrome in type 2 diabetes mellitus using NCEP-ATPIII, IDF and WHO definition and its agreement in Gwalior Chambal region of Central India. Global journal of health science 2013; 5: 142.
6. Trevisan M, Liu J, Bahsas FB, Menotti A. Syndrome X and mortality: a population-based study. Risk Factor and Life Expectancy Research Group. Am J Epidemiol 1998; 148: 958-66.
7. Laaksonen DE, Niskanen L, Nyyssonen K et al. C-reactive protein and the development of the metabolic syndrome and diabetes in middle-aged men. Diabetologia 2004; 47: 1403-10.
8. Srikanthan K, Feyh A, Visweshwar H, Shapiro JI, Sodhi K. Systematic review of metabolic syndrome biomarkers: a panel for early detection, management, and risk stratification in the West Virginian population. International journal of medical sciences 2016; 13: 25.
9. Saltiel AR, Olefsky JM. Inflammatory mechanisms linking obesity and metabolic disease. The Journal of Clinical Investigation 2017; 127: 1-4.
10. Ryliskyte L, Navickas R, Serpytis P et al. Association of aortic stiffness, carotid intima-media thickness and endothelial function with cardiovascular events in metabolic syndrome subjects. Blood Press 2019; 28: 131-8.
11. Lim S, Taskinen MR, Boren J. Crosstalk between nonalcoholic fatty liver disease and cardiometabolic syndrome. Obes Rev 2019; 20: 599-611.
12. Bierman EL. George Lyman Duff Memorial Lecture. Atherogenesis in diabetes. Arterioscler Thromb 1992; 12: 647-56.
13. Lotufo PA, Gaziano JM, Chae CU et al. Diabetes and all-cause and coronary heart disease mortality among US male physicians. Arch Intern Med 2001; 161: 242-7.
14. Hu FB, Manson JE, Stampfer MJ et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med 2001; 345: 790-7.
15. Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB. The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med 2003; 163: 427-36.
16. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998; 15: 539-53.
17. Wang GW, Klein JB, Kang YJ. Metallothionein inhibits doxorubicin-induced mitochondrial cytochrome c release and caspase-3 activation in cardiomyocytes. J Pharmacol Exp Ther 2001; 298: 461-8.
18. Alberti KG, Zimmet P, Shaw J. Metabolic syndrome--a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med 2006; 23: 469-80.
19. Balkau B, Charles MA, Drivsholm T et al. Frequency of the WHO metabolic syndrome in European cohorts, and an alternative definition of an insulin resistance syndrome. Diabetes Metab 2002; 28: 364-76.
20. Einhorn D, Reaven GM, Cobin RH et al. American College of Endocrinology position statement on the insulin resistance syndrome. Endocr Pract 2003; 9: 237-52.
21. Alberti KG, Eckel RH, Grundy SM et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120: 1640-5.
22. Grundy SM, Brewer HB, Jr., Cleeman JI, Smith SC, Jr., Lenfant C. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 2004; 109: 433-8.
23. Ridker PM, Buring JE, Cook NR, Rifai N. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14 719 initially healthy American women. Circulation 2003; 107: 391-7.
24. Grundy SM, Cleeman JI, Daniels SR et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735-52.
25. Grundy SM. Does the metabolic syndrome exist? Diabetes Care 2006; 29: 1689-92; discussion 93-6.
26. Grundy SM. Metabolic syndrome: a multiplex cardiovascular risk factor. J Clin Endocrinol Metab 2007; 92: 399-404.
27. Alberti KG, Zimmet P, Shaw J. The metabolic syndrome--a new worldwide definition. Lancet 2005; 366: 1059-62.
28. Consensus Development Conference on Insulin Resistance. 5-6 November 1997. American Diabetes Association. Diabetes Care 1998; 21: 310-4.
29. Isomaa B. A major health hazard: the metabolic syndrome. Life Sci 2003; 73: 2395-411.
30. Alexander CM, Landsman PB, Teutsch SM, Haffner SM. NCEP-defined metabolic syndrome, diabetes, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes 2003; 52: 1210-4.
31. Wang Q, Chair SY, Wong EM-L, Taylor-Piliae RE, Qiu XCH, Li XM. Metabolic Syndrome Knowledge among Adults with Cardiometabolic Risk Factors: A Cross-Sectional Study. International journal of environmental research and public health 2019; 16: 159.
32. Osei-Yeboah J, Owiredu WK, Norgbe GK et al. The Prevalence of Metabolic Syndrome and Its Components among People with Type 2 Diabetes in the Ho Municipality, Ghana: A Cross-Sectional Study. International journal of chronic diseases 2017; 2017.
33. Klein BE, Klein R, Lee KE. Components of the metabolic syndrome and risk of cardiovascular disease and diabetes in Beaver Dam. Diabetes Care 2002; 25: 1790-4.
34. Shin JA, Lee JH, Lim SY et al. Metabolic syndrome as a predictor of type 2 diabetes, and its clinical interpretations and usefulness. Journal of diabetes investigation 2013; 4: 334-43.
35. Zhang ML, Hou XH, Zhu YX et al. Metabolic disorders increase the risk to incident cardiovascular disease in middle-aged and elderly Chinese. Biomed Environ Sci 2012; 25: 38-45.
36. Kokubo Y, Okamura T, Yoshimasa Y et al. Impact of metabolic syndrome components on the incidence of cardiovascular disease in a general urban Japanese population: the suita study. Hypertens Res 2008; 31: 2027-35.
37. Weiss R, Dziura J, Burgert TS et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004; 350: 2362-74.
38. DuBose KD, Stewart EE, Charbonneau SR, Mayo MS, Donnelly JE. Prevalence of the metabolic syndrome in elementary school children. Acta Paediatr 2006; 95: 1005-11.
39. Morrison JA, Sprecher DL, Barton BA, Waclawiw MA, Daniels SR. Overweight, fat patterning, and cardiovascular disease risk factors in black and white girls: The National Heart, Lung, and Blood Institute Growth and Health Study. J Pediatr 1999; 135: 458-64.
40. Ford ES. Insulin resistance syndrome: the public health challenge. Endocr Pract 2003; 9 Suppl 2: 23-5.
41. Wilson PW, D'Agostino RB, Parise H, Sullivan L, Meigs JB. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation 2005; 112: 3066-72.
42. Brown SA, Hutchinson R, Morrisett J et al. Plasma lipid, lipoprotein cholesterol, and apoprotein distributions in selected US communities. The Atherosclerosis Risk in Communities (ARIC) Study. Arterioscler Thromb 1993; 13: 1139-58.
43. Laws A, Hoen HM, Selby JV, Saad MF, Haffner SM, Howard BV. Differences in insulin suppression of free fatty acid levels by gender and glucose tolerance status. Relation to plasma triglyceride and apolipoprotein B concentrations. Insulin Resistance Atherosclerosis Study (IRAS) Investigators. Arterioscler Thromb Vasc Biol 1997; 17: 64-71.
44. Kekalainen P, Sarlund H, Pyorala K, Laakso M. Hyperinsulinemia cluster predicts the development of type 2 diabetes independently of family history of diabetes. Diabetes Care 1999; 22: 86-92.
45. Hanson RL, Imperatore G, Bennett PH, Knowler WC. Components of the "metabolic syndrome" and incidence of type 2 diabetes. Diabetes 2002; 51: 3120-7.
46. Lorenzo C, Okoloise M, Williams K, Stern MP, Haffner SM. The metabolic syndrome as predictor of type 2 diabetes: the San Antonio heart study. Diabetes Care 2003; 26: 3153-9.
47. Ford ES. Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the U.S. Diabetes Care 2005; 28: 2745-9.
48. Kim SH, Després J-P, Koh KK. Obesity and cardiovascular disease: friend or foe? European heart journal 2015; 37: 3560-8.
49. Lakka HM, Laaksonen DE, Lakka TA et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002; 288: 2709-16.
50. Bonora E, Formentini G, Calcaterra F et al. HOMA-estimated insulin resistance is an independent predictor of cardiovascular disease in type 2 diabetic subjects: prospective data from the Verona Diabetes Complications Study. Diabetes Care 2002; 25: 1135-41.
51. Ninomiya JK, L'Italien G, Criqui MH, Whyte JL, Gamst A, Chen RS. Association of the metabolic syndrome with history of myocardial infarction and stroke in the Third National Health and Nutrition Examination Survey. Circulation 2004; 109: 42-6.
52. Hu G, Qiao Q, Tuomilehto J, Balkau B, Borch-Johnsen K, Pyorala K. Prevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. Arch Intern Med 2004; 164: 1066-76.
53. Campbell B, Aguilar M, Bhuket T, Torres S, Liu B, Wong RJ. Females, Hispanics and older individuals are at greatest risk of developing metabolic syndrome in the US. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2016; 10: 230-3.
54. Kaur J. A comprehensive review on metabolic syndrome. Cardiology research and practice 2014; 2014.
55. Wong ND, Zhao Y, Patel R et al. Cardiovascular risk factor targets and cardiovascular disease event risk in diabetes: a pooling project of the Atherosclerosis Risk in Communities Study, Multi-Ethnic Study of Atherosclerosis, and Jackson Heart Study. Diabetes care 2016; 39: 668-76.
56. Wagh A, Stone NJ. Treatment of metabolic syndrome. Expert Rev Cardiovasc Ther 2004; 2: 213-28.
57. Deedwania PC, Volkova N. Current Treatment Options for the Metabolic Syndrome. Curr Treat Options Cardiovasc Med 2005; 7: 61-74.
58. Rask Larsen J, Dima L, Correll CU, Manu P. The pharmacological management of metabolic syndrome. Expert Rev Clin Pharmacol 2018; 11: 397-410.
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Metabolic syndrome criteria and its association with type 2 diabetes and cardiovascular diseases. Progr Nutr [Internet]. 2020 Jun. 12 [cited 2024 Jun. 30];22(2):361-9. Available from: https://mattioli1885journals.com/index.php/progressinnutrition/article/view/8316
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How to Cite
1.
Metabolic syndrome criteria and its association with type 2 diabetes and cardiovascular diseases. Progr Nutr [Internet]. 2020 Jun. 12 [cited 2024 Jun. 30];22(2):361-9. Available from: https://mattioli1885journals.com/index.php/progressinnutrition/article/view/8316
