Re: Metabolic syndrome doesn't exist, diabetes groups claim

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On Sat, 27 Aug 2005 03:38:52 GMT, "rich" <dummyaddress@xxxxxxxxxxx>
wrote:

>
>"Quentin Grady" <quentin@xxxxxxxxxxxxxxx> wrote in message
>news:pfqug1thtn32ddmv53mhdgrj5qpg78o6ip@xxxxxxxxxx
>
>> The contrary argument which appears to be the one they are following
>> is that if the cluster of risks is the simple sum of it parts then
>> there is no need to believe in something greater than the simple sum.
>> Deal with high blood pressure, deal with high blood glucose, deal with
>> high triglycerides and low HDL, deal with abdominal obesity. Stop
>> believing in something greater than the sum of these risk factors.
>
>Howdy, Quentin:
>
>But even if the risk factors are merely additive, isn't that glossing over
>the (very real, IMO) possibility that these perceived different risk factors
>may actually have some cause(s) in common? And that if that root cause is
>addressed then several (or maybe even all) of the risk factors may be
>alleviated?

G'day G'day Rich,

I tend to think along similar lines to you in this matter. It is a
bit like Pandora's box. If you open the lid and say "Yeap, there is a
common cause." then one has to question of treating each of the
symptoms separately. When the C-reactive protein, CRP test was first
discovered it wasn't all that useful. The test lacked sensitivity and
folks with measurable elevated CRP were pretty obviously ill. When a
test with improved sensitivity, high sensitivity CRP, hs-CRP was
introduced it was found to correlate BETTER than cholesterol in
predicting heart attacks. Elevated CRP was also found in people with
high blood pressure, obesity and T2 diabetes.

It would appear the smoking gun has been found or has it? The tenor
of the ADA position appears to be that there is NO underlying cause.

>
>> 4. Absence of underlying mechanism.
>>
>> This is an old argument. Put simply a cluster of risk factors exist
>> for coronary heart disease, T2 diabetes etc. Are they one disease with
>> multiple symptoms or are they multiple diseases that just happen to
>> frequently occur to together?
>>
>> The ADA position appears to be at the moment that there isn't one
>> underlying cause ie that folks diagnosed with metabolic syndrome have
>> stuffed themselves up severally rather than in some way that has had
>> multiple symptoms.
>>
>> There are those who believe there is ONE underlying disorder, silent
>> inflammatory disorder.
>
>OK, this is what I was talking about. I think that which way occam's razor
>cuts depends on some stats that I don't know. If the clustering of symptoms
>occurs at a statistically significant level wouldn't occam's razor say that
>assuming multiple causes for a linked group of symptoms is an unnecessary
>complication?

Good argument. The ADA position at the moment appears to be that the
clustering is ill defined. Fair enough.

How does one define a cluster unambiguously?

Look at the changes that have been made in the official definition of
T2 diabetes over the years. Of course definitions change as new ones
are found to be more helpful in defining the population that need
and/or will respond to treatment.

To me the ambiguity of definition is all a bit of a red herring.

It is like saying the term "regular smoker" is defined differently by
different researchers so we shouldn't believe regular smokers exist.

>The simple explanation would be that there is one underling
>factor that is causing the linked group of symptoms?
>
>Thanks for giving us a little more in depth view of the issue.
>
>Rich

And thank you,

Best wishes,


--
Quentin Grady ^ ^ /
New Zealand, >#,#< [
/ \ /\
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin
.

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