Is it necessary to detect insulin resistance for diagnosis of metabolic syndrome in clinical practice?

Metabolic syndrome is widely spread in population especially among subjects with risk factors of atherosclerosis related diseases. Since 1988 criteria of metabolic syndrome have undergone substantial transformation. Technical difficulties related to detection of insulin resistance created obstacles to application of the term "metabolic syndrome" in clinical practice. In 2001 experts of National Cholesterol Education Program in USA suggested new set of criteria. The presence of 3 or more of the following 5 components (abdominal obesity, hypertriglyceridernia, low level of high density lipoprotein cholesterol, hypertension and high fasting blood glucose) allows to diagnose metabolic syndrome. These worldwide used criteria do not imply detection of insulin resistance. Feasibility of this approach has been confirmed by analysis of correlation between presence of markers of insulin resistance and that of metabolic syndrome according to novel criteria. This analysis has shown that combination of 3 or more components is significantly associated with insulin resistance.