Third Annual World Congress on the Insulin Resistance Syndrome
Mediators, antecedents, and measurement
- Zachary T. Bloomgarden, MD, is a practicing endocrinologist in New York, New York, and is affiliated with the Division of Endocrinology, Mount Sinai School of Medicine, New York, New York
- AACE, American Association of Clinical Endocrinologists
- ATP, Adult Treatment Panel
- CVD, cardiovascular disease
- FFA, free fatty acid
- G6P, glucose-6-phosphate
- HOMA, homeostasis model assessment
- IGT, impaired glucose tolerance
- IL, interleukin
- NMR, nuclear magnetic resonance
- PC-1, placmacytoma-1
- PGC, peroxisome proliferator–activated receptor γ coactivator
- PI3K, phosphatidylinositol-3-kinase
- SSPG, steady-state plasma glucose
- TNF, tumor necrosis factor
- TZD, thiazolidinedione
This is the first of three articles reviewing presentations at the 3rd Annual World Congress on the Insulin Resistance Syndrome, San Francisco, California, 17–19 November 2005.
Yehuda Handelsman (Tarzana, CA) introduced the 3rd Annual World Congress on the Insulin Resistance Syndrome and discussed the state of the insulin resistance syndrome, recalling its beginning in 1988 with Gerald Reaven’s proposal that “Syndrome X” comprises a group of risk factors linked by insulin resistance, with the World Health Organization definition of metabolic syndrome in 1999, the modified definition proposed by the European Group on Insulin Resistance in 2001/20022, and the widely used Adult Treatment Panel (ATP)-III metabolic syndrome definition given by National Cholesterol Education Panel in 2001. Handelsman pointed out that the American Association of Clinical Endocrinologists (AACE) helped to gain the ICD-9 code of 277.7 for the constellation of conditions also termed the “metabolic” or the “dysmetabolic” syndrome, and he noted that the AACE definition of the syndrome adds the concept of differently assessing persons who belong to high-risk groups. The insulin resistance syndrome represents a continuum of risk, he stated, showing the use of the AACE-defined insulin resistance syndrome in predicting diabetes independently of glucose levels. Handelsman further reviewed what he termed the “war of the syndromes,” which followed the International Diabetes Federation proposal for another definition in April 2005, placing central obesity as the defining characteristic of the syndrome and pointing out the need for ethnic group–specific criteria. The American Diabetes Association/European Association for the Study of Diabetes position statement in September 2005 said, in effect, that “there is no syndrome” and questioned whether the syndrome is actually useful in predicting cardiovascular disease (CVD). This was followed in the same month by the American Heart Association position statement insisting “yes, there is a syndrome,” including central obesity as one …
