New Statement Reaffirms Insulin Resistance Syndrome Definition
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Recently, several medical organizations have published statements reflecting changes in their definitions and assessment of “Metabolic Syndrome” (MS). Because of concern that these statements would create uncertainty and controversy among physicians and further confuse the general public, the American College of Endocrinology (ACE) and American Association of Clinical Endocrinologists (AACE) empowered a rapid response team to assess these statements and review their position in the new ACE and AACE: Reaffirmation of the 2003 ACE Insulin Resistance Syndrome (IRS) Position Statement.
According to the 2003 ACE Position Statement, IRS describes the cluster of abnormalities that are more likely to occur in insulin resistant/hyperinsulinemic individuals. The statement goes on to explain the label “metabolic syndrome” relies on an unclear definition of “metabolic” and is likely to become even less appropriate as the abnormalities associated with insulin resistance and compensatory hyperinsulinemia continue to be elucidated.
People with resistance to the actions of insulin have an increased risk of diabetes and cardiovascular disease, as well as polycystic ovary syndrome, fatty liver, and certain cancers. Obesity and sedentary lifestyle contribute to the development of insulin resistance. IRS risk factors include overweight/obesity, high triglyceride levels, low HDL cholesterol, high blood pressure and elevated two-hour post-prandial glucose values.
“The IRS concept was designed to help physicians predict and prevent serious complications from a number of conditions such as cardiovascular disease and diabetes. The term ‘syndrome’ suggests a relationship among factors in the cluster, even if the underlying pathophysiology may not be completely understood,” stated Bill Law Jr., MD, FACP, FACE, AACE President.
“We recognize that there is an academic difference in discussing the various clinical manifestations of insulin resistance and calling the cluster a syndrome,” commented Law. “However, for didactic and practical purposes, the term syndrome is conceptually attractive and clinically useful.”
In 2002 ACE and AACE took a prominent role in defining IRS by gathering key thought leaders at a consensus conference in Washington, DC. As a result of this conference, the ACE Position Statement on IRS was written and has served as the standard for diagnosis and treatment of IRS.
“The research, diagnosis and treatment of IRS is rapidly evolving and we expect changes in definitions and understanding as new evidence is presented,” commented Daniel Einhorn, MD, FACE, Co-Chair of the ACE and AACE IRS Consensus Conference. “With regard to this evolution, ACE and AACE hope that healthy debate will not be misconstrued as fractious controversy and that further research in this field will clarify the remaining areas of uncertainty.”
Visit http://www.aace.com for the complete position statement and more information on IRS.
AACE is a professional medical organization with more than 5,200 members in the United States and 84 other countries. Founded in 1991, AACE is dedicated to the optimal care of patients with endocrine problems. AACE initiatives inform the public about endocrine disorders. AACE also conducts continuing education programs for clinical endocrinologists, physicians whose advanced, specialized training enables them to be experts in the care of endocrine diseases, such as diabetes, thyroid disorders, growth hormone deficiency, osteoporosis, cholesterol disorders, hypertension and obesity. For more information, visit http://www.aace.com.
ACE is the scientific arm of AACE with the mission of providing and promoting education, research and communication in the art and science of clinical endocrinology and to provide appropriate recognition of advances and achievements relating to clinical endocrinology.
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