Glycemic control in the metabolic syndrome and implications in preventing cardiovascular disease.

The metabolic syndrome represents a cluster of cardiovascular risk factors that occur together more commonly than expected from the prevalence of their individual rates. Insulin resistance is widely believed to be the common denominator causing, in susceptible individuals, the development of various cardiovascular risk factor components of the syndrome (e.g., hyperlipidemia, hypertension, and hyperglycemia). The major cause of this insulin resistance appears to be obesity, especially the accumulation of visceral fat. This obesity is due to the combination of excessive caloric intake and inadequate physical activity rather than alterations in energy utilization. In individuals whose beta cells cannot increase their insulin secretion adequately to compensate for insulin resistance, hyperglycemia occurs.