The Metabolic Syndrome

Dear Sirs,

in your editorial of June 2003 ([Schatz and Wehling, 2003]), you have commented on the opening of the “metabolic syndrome institute”. It is good news to hear that one of the most challenging health problems of our days will now be tackled in a concerted effort. We are glad that you reported some of the contributions of German medicine to the awareness of the metabolic syndrome. You correctly cited the paper of [Mehnert et al. from 1968] on the affluence syndrome and a review by Hanefeld.

However, the relation of obesity and diabetes was already described by [Bouchardat in 1875]. [Neubauer] described the association of hypertension and hyperglycaemia in 1910, and was confirmed by [Hitzenberger and Richter-Quittner in 1921], who described the coincidence of hypertension, hyperglycaemia and hyperuricaemia. However, the term “metabolic syndrome” was first introduced by Jahnke et al. in a plenary lecture at the 6th congress of the International Diabetes Federation in 1967 at Stockholm ([Jahnke et al., 1969]), where the syndrome was characterised as the association of obesity, impaired glucose tolerance, hyperinsulinemia (measured biologically and by radioimmunoassay) as a marker of insulin resistance, elevated concentrations of plasma free fatty acids and triglycerides as indicators of dyslipidaemia. One year later, the same group ([Liebermeister et al., 1968]) showed that a moderate weight loss in patients suffering from the metabolic syndrome leads to a significant reduction of blood levels for glucose, triglycerides and insulin.

Since those days, our knowledge of the metabolic syndrome has expanded tremendously and it has now been shown and acknowledged by the [WHO (1997)] that the syndrome plays an important role in many of the most affecting health problems of modern societies.

The readers of this journal may appreciate to know about the origins of the term, its first biochemical and clinical characterization and one of the first clinical trials in obese patients.

Yours sincerely,

F. A. Gries H. Liebermeister

References

• 1 Bouchardat A. De la glycosurie ou diabète sucré. Paris; Germer-Baillière 1875
• 2 Hanefeld M, Leonhardt W. Das metabolische Syndrom.  Dtsch Gesundh Wesen. 1981;  36 545-551
• 3 Hitzenberger K, Richter-Quittner M. Ein Beitrag zum Stoffwechsel bei der vaskulären Hypertonie.  Arch Inn Med. 1921;  2 189-216
• 4 Jahnke K, Daweke H, Liebermeister H, Schilling W H, Thamer G, Preiss H, Gries F A. Hormonal and metabolic aspects of obesity in humans. Proceedings of the sixth congress of the International Diabetes Federation 1967. Ostmann J (ed) Excerpta Medica. 1969: 533-539
• 5 Liebermeister H, Daweke H, Gries F A, Schilling W H, Grüneklee D, Herberg L, Jahnke K. Einfluss der Gewichtsreduktion auf Metabolite des Kohlenhydrat- und Fettstoffwechsels und auf das Verhalten des Seruminsulins bei Fettsucht.  Diabetologia. 1968;  4 23-32
• 6 Mehnert H, Kuhlmann H. Hypertonie und Diabetes mellitus.  Dtsch Med Wschr. 1968;  19 567-571
• 7 Neubauer E. Über Hyperglykaemie bei Hochdrucknephritis.  BZ. 1910;  25 284
• 8 Schatz H, Wehling M. Fighting against the “hypertriglyceridaemic waist”. A new International Institute for the Metabolic Syndrome.  Exp Clin Endocrinol Diabetes. 2003;  11 119-120
• 9 WHO .Obesity: Preventing and Managing a Global Epidemic. Report of a WHO Consultation on Obesity. Geneva, June 3 - 5,. 1997