Metabolic syndrome (described in France in the 1940s by Dr. J. Vague and characterised in 1988 by G.M. Reaven in the US), has been recognised and studied since few years. Although 2 main definitions are used, one by the WHO and the other by the National Cholesterol Education Program (NCEP-ATPIII), these have in common the consideration of a cluster of risk factors: blood pressure > 130-85 mm Hg, HDL-C cholesterol < 40 mg/dl in men, < 50 mg/dl in women, triglycerides >150 mg/dl, glycaemia >1.10g/l and waist circumference > 102 cm for men and >88 cm for women.

Although the threshold set for each of these metabolic parameters is lower than the pathological threshold, the risk of experiencing cardiovascular accidents, as we have just seen, is considerably enhanced. It is therefore the combination of these metabolic disorders, rather than the level of each, that constitutes a veritable time-bomb.

Approximately 1 adult in 4 or 5 - depending on the country - shows Metabolic Syndrome, and the older the population the higher the incidence. In the over 50s category, Metabolic Syndrome affects more than 40 % of the population in the United States and nearly 30 % in Europe.

In the same way that, an almost exponential increase in type II diabetes and obesity (FIGURE IV and V) is noticed, Metabolic Syndrome is substantially on the increase.

Prevalence varies from one country to another for a multitude of reasons. Many of these have yet to be identified though genetic predisposition and environmental factors such as sedentary lifestyle and certain eating habits are already known: the United States and northern rather than southern European countries show a very high prevalence. And prevalence is skyrocketing in central Europe. Finally, ethnic differences have been observed in the United States where Afro-Americans and Mexicans are more affected than Caucasians.

What can be done to counter this increase ? How is it possible in current medical practice to pick out these patients since they do not suffer from any illness easily recognisable using standard diagnostic criteria ?