The Concept of CMR
Definition and History
Obesity and insulin resistance have been linked to a series of complications for over 40 years. The metabolic syndrome refers to a cluster of metabolic abnormalities caused by insulin resistance, which is often associated with a high-risk form of overweight/obesity: intra-abdominal (visceral) obesity. Because these abnormalities increase the risk of cardiovascular disease (CVD) and type 2 diabetes, numerous consensus groups have proposed clinical tools to identify individuals with these atherogenic and diabetogenic metabolic complications. The debate continues as to whether features of the metabolic syndrome increase CVD risk beyond the risk posed by traditional CVD risk factors. This debate has spurred the creation of a new concept: global cardiometabolic risk (CMR). CMR encompasses overall CVD risk resulting from traditional risk factors (age, sex, smoking, hypertension, LDL cholesterol, HDL cholesterol, diabetes) and from the additional risks of intra-abdominal obesity and related features of the metabolic syndrome.