الفهرس 
Etiology, Risk Factors and pathophysiology of Metabolic Syndrome and ItsOnly 14 pages are availabe for public view
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Abstract
In this essay review the metabolic syndrome was discussed together with its relation to different diseases, risk factors, its animal models and recent methods of its management.
The term metabolic syndrome is used for describing a group of cardiovascular risk factors including abdominal obesity, glucose intolerance or type 2 diabetes mellitus, dyslipidaemia and hypertension. A concomitant presentation of all components of the syndrome is rare; therefore, in the view of most experts three out of the four main components are sufficient for defining the syndrome.
The exact mechanisms of the complex pathways of metabolic syndrome are not completely known. However a lot of risk factors are associated with it like visceral obesity, aging, sedentary life style and family history.
Visceral obesity seems to be the main driving factor causing increased production of free fatty acids whose activity, in turn, interferes with the action of insulin causing insulin resistance. Increased adiposity leads to increase in inflammatory cytokines like TNF-alpha, IL6 and CRP as well as increase in adipokines (leptin and resisitin) at the same time adiponectindecreses. When this inflammatory state develops, it leads to a sort of endothelial dysfunction and hence insulin resistance appears. A prothrombotic state (increased PAI-1) and increased angiotensin II level leads to development of atherosclerosis and hypertension. This totally leads to development of different cardiovascular risk factors including atherosclerosis that in return leads to more hypertension, more development of dyslipidemia and hence more atherosclerosis that it why it looks like a vicious circle. So, the end of obesity is not known till now.
The peroxisome proliferator-activated receptors (PPARs) are a group of nuclear receptor proteins that function as transcription factors regulating the expression of genes. PPARs play essential roles in the regulation of cellular differentiation, development, and metabolism that is why their manipulation plays an important role in the development and pathogenesis as well as treatment or management of metabolic syndrome.
Management of metabolic syndrome is still controversial and under investigation. Many of drugs developed throughout the last 10 years, some of them showed marked improvement, others were removedfrom the market because of their hazards or side effects. Combination of two or three drugs (polypill) was also tried and still under investigation. Recently, the researchers were directed to the major metabolic switch which is considered as the most promising field in treatment of metabolic syndrome now.
In conclusion, a number of questions about the metabolic syndrome regarding its final definition, pathogenesis and treatment were answered but there are still some questions that till now remain unanswered.