Talk:Metabolic syndrome

I
I am very much inclined to move this article to metabolic syndrome, which seems to be accepted nomenclature (see J Clin Endocrinol Metab of June 2004). Any views or comments?? JFW | T@lk  10:47, 8 Jun 2004 (UTC)

Agree. Current nomenclature is metabolic syndrome. Maintain redirect, of course. Kd4ttc 02:37, 9 Jun 2004 (UTC)

note that on your section with regards to diagnostic criteria - you include six criteria, not five. i wasn't aware that an elevated CRP was one of the criteria. alex tan.


 * You are completely right. I have no idea who inserted that. Thanks. JFW | T@lk  12:51, 31 October 2005 (UTC)

I agree with your observation on this .I also beleive that given the fact the patient with metabolic syndrome have high incidence of cardiovascular disease.It would be even prudent to call it cardiometabolic syndrome as some of the recent leading researched in this field having been doing.


 * I have not heard the term "cardiometabolic syndrome". It may not be notable enough to be mentioned in the article. JFW | T@lk  20:34, 14 February 2006 (UTC)


 * Heh. It was coined by Sanofi-Aventis to push rimonabant. I hear it in active use all the time now :-). JFW | T@lk  12:47, 12 May 2008 (UTC)

War is over
Apparently the AHA and ADA differed in how the metabolic syndrome should be addressed. They have now agreed on some things. Do we include this?. JFW | T@lk  10:42, 21 August 2006 (UTC)

don't think the war is completely over - at the 2006 ADA conference, alberti and kahn were presenting arguments for the different diagnostic criteria for the syndrome (WHO/IDF vs ADA/EASD). there were also comments about whether it was necessary at all to have the metabolic syndrome label... identify CVS risk factors individually and treat accordingly.

Dysmetabolic syndrome
I don't understand why it is called "metabolic" syndrome when it really is a dysmetabolic syndrome. Everyone has a metabolic syndrome: well, everyone that's living that is. I know it is overwhelmingly standard to not use the dys- prefix, but are there any sources arguing my point that "metabolic syndrome" is misnamed? Practically every medical term I can think of relies on proper use of suffixes, prefixes, and root words (see List of medical roots) and this seems to go against that. Sloppy terminology, if you will. Cburnett 04:36, 7 December 2006 (UTC)


 * I don't have much experience at Wikipedia, but it seems to me that an encyclopedia should be DEscriptive, not PREscriptive. That is, Wikipedia should not tell the medical community what terminology SHOULD BE used, but should report using the terminology that IS used.Rocky143 05:17, 4 January 2007 (UTC)


 * I thought I made it pretty clear; I repeat:
 * ...are there any sources arguing my point that "metabolic syndrome" is misnamed?
 * I am NOT saying wikipedia should dictate. I am stating that I think it's wrong and I am ASKING if any one knows of any sources regarding it being misnamed.  If dysmetabolic syndrome can be sourced then WP is not dictating, it's reporting. Cburnett 05:50, 4 January 2007 (UTC)

mmol/L and mg/dL
Someone who knows how should supply mg/dL figures to supplement the mmol/L figures in this article.Rocky143 05:18, 4 January 2007 (UTC)

Metformin
The article about treatment is misleading, it says that the treatment of insulin resistance by Metformin is not FDA approved, but if you go to the article on Metformin it says that it is FDA approved. So which is it?

--> Metformin is approved for treatment of type 2 diabetes, not metabolic syndrome —Preceding unsigned comment added by 68.45.246.66 (talk) 12:53, 1 September 2007 (UTC)

I changed some stuff.
I removed the symptoms in the first section because they were duplicated in the diagnosis section. I also added the citation for Grundy. Rhetth 00:20, 14 July 2007 (UTC)

Elevated CRP and TNF-alpha
I have read in some sources that indeed these are elevated in metabolic syndrome. Can anyone with greater knowledge confirm this? Russthomas15 07:13, 14 November 2007 (UTC)


 * hsCRP is a marker not of metabolic syndrome but probably atherosclerotic burden. In a patient with MetS who also has a high CRP (and no evidence of infection or autoimmune disease) there is good reason to be a bit nervous.
 * TNFα is secreted by monocytes that have populated adipose tissue. It is a marker of obesity, again in patients who have other confounding conditions. It is not measured routinely and probably of limited clinical relevance. Interestingly, patients who receive infliximab (a TNF inhibitor) tend to get better glycaemic control when diabetic, suggesting that TNF does play a role in insulin resistance. JFW | T@lk  12:51, 12 May 2008 (UTC)

Added
This reference was left on the userpage:


 * Ford ES, Giles WH, Dietz WH: Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 287:356–359, 2002

It looks useful, but it had no content associated with it. JFW | T@lk  21:16, 16 January 2008 (UTC)

I put this reference back in with a link to the PubMed article. Dcwebb (talk) 16:09, 21 May 2008 (UTC)

Ouch
In the Cardiovascular Health Study, diagnosis of metabolic syndrome by either WHO or IDF criteria made little difference in mortality compared to simply diagnosing and treating hypertension and elevated fasting glucose (EFG). Food for thought, and probably part of a trend against the use of metabolic syndrome as a bona fide diagnosis. JFW | T@lk  12:45, 12 May 2008 (UTC)


 * Arch Intern Med 2008;168:969-978 JFW | T@lk  12:53, 12 May 2008 (UTC)

Simply new terminology?
Isn't this syndrome basically obesity, caused by the usual factors attributed to obesity, such as diet, lack of exercise, etc.? Everyone knows obesity greatly increases one's risks of things like cardiovascular disease and diabetes, the same things mentioned here. I live in Japan and it's commonly said when a person's waist goes beyond a certain number of centimetres, they have metabo (i.e. metabolic syndrome). I always thought this was a bit silly, thinking 'No, they're just getting fat.' Are the two not really one and the same--i.e. the same symptoms and risk factors? Just seems to me like this is a politically correct trend word. 122.102.237.156 (talk) 03:23, 17 May 2009 (UTC)


 * Not if the syndrome leads to obesity - as in the case of insulin resistance. — Preceding unsigned comment added by 114.111.151.37 (talk) 02:00, 29 June 2011 (UTC)


 * I think you've got that backwards. The weight gain causes insulin resistance. JFW &#124; T@lk  06:26, 29 June 2011 (UTC)

Diagnosis
There are currently two major definitions for metabolic syndrome provided by the International Diabetes Federation and the revised National Cholesterol Education Program, respectively. The revised NCEP and IDF definitions of metabolic syndrome are very similar and it can be expected that they will identify many of the same individuals as having metabolic syndrome. The two differences are that IDF state if BMI>30 kg/m3 central obesity can be assumed and waist circumference does not need to be measured, however this potenitally excludes any subject without increased waist circumference if BMI<30, while in the NCEP definition metabolic syndrome can be diagnosed based on other criteria and the IDF uses geography-specific cut points for waist circumference, while NCEP uses only one set of cut points for waist circumference regardless of geography. These two definitions are much closer to each other than the original NCEP and WHO definitions.

IDF
2006 :International Diabetes Federation


 * Central obesity (defined as waist circumference** with ethnicity specific values)

plus any two of the following four factors following four factors:

>150 mg/dL (1.7 mmol/L) or specific treatment for this lipid abnormality < 40 mg/dL (1.03 mmol/L) in males < 50 mg/dL (1.29 mmol/L) in females or specific treatment for this lipid abnormality systolic BP >130 or diastolic BP 85 mm Hg or treatment of previously diagnosed hypertension (FPG)>100 mg/dL (5.6 mmol/L), or previously diagnosed type 2 diabetes If FPG >5.6 mmol/L or 100 mg/dL, OGTT is strongly recommended but is not necessary to define presence of the Syndrome
 * Raised triglycerides
 * Reduced HDL cholesterol
 * Raised blood pressure
 * Raised fasting plasma glucose
 * If BMI is >30kg/m², central obesity can be assumed and waist circumference does not need to be measured

Stress
Can we please have a vote on this. I believe that since the actual wiki article on Stress (biology) actually links stress with visceral fat and consequently imbalances in hormonal and metabolic symptoms leading to heart disease. The author Malcolm Kendrick simply states that this is a manifestation of Metabolic syndrome. This is not an unorthodox view.

Quote from Stress (biology)wiki article:

Studies of female monkeys at Wake Forest University (2009) discovered that individuals suffering from higher stress have higher levels of visceral fat in their bodies. This suggests a possible cause-and-effect link between the two, wherein stress promotes the accumulation of visceral fat, which in turn causes hormonal and metabolic changes that contribute to heart disease and other health problems. 122.107.141.196 (talk) 02:21, 9 December 2009 (UTC)

What's wrong with you guys? Will no one debate me? Here are further links connecting stress with Metabolic syndrome: http://stress.about.com/od/stresshealth/a/jobstress.htm http://www.docguide.com/news/content.nsf/news/8525697700573E1885256C7800219682

This one is an actual scientific study. If you don't like Malcolm Kendrick as a reference, then try this one: http://www.bmj.com/cgi/content/abstract/332/7540/521

It states:

Objectives To investigate the association between stress at work and the metabolic syndrome

Conclusions Stress at work is an important risk factor for the metabolic syndrome. The study provides evidence for the biological plausibility of the link between psychosocial stressors from everyday life and heart disease 122.107.141.196 (talk) 17:56, 9 December 2009 (UTC)


 * A couple of things. First, this is not a vote. Secondly, I will not respond to rants like "What's wrong with you guys?" Thirdly, please have a quick glance at WP:MEDRS, which will provide a backdrop to almost everything I am about to explain.
 * Malcolm Kendrick is not mainstream. Anyone who writes a book for the popular press called "The Great Cholesterol Con" is not mainstream and clearly is not pretending to be. We cannot therefore treat his work as mainstream, however much you believe that he is mainstream, because his actions speak louder than your words.
 * If you want to say more about stress and metabolic syndrome, or the hypothalamic-pituitary-adrenal axis and metabolic syndrome, be my guest. But please stick to sources as outlines in MEDRS. Basically, sources need to be from peer-reviewed publications and be so-called "secondary sources" (reviews, meta-analyses etc). Anything less will not do, especially in a heavily researched topic such as metabolic syndrome. JFW | T@lk  20:38, 14 December 2009 (UTC)

Firstly, it seemed that no one wanted to engage me in a discussion so I provoked a response which seems to have now worked. Secondly, I have read Kendrick's book and you have not. The first 3/4 of his book is based on the debunking of the Lipid hypothesis which I knew was not a mainstream view. However, the final 1/4 of his book deals with the idea that stress is the underlying cause of Metabolic syndrome which results in obesity and heart disease. I was subsequently able to find many research papers that backed up this idea. However, I was not aware that on Wiki even though an author may have a verified thesis, if he himself is not a reputable person, then he cannot be used as a source.

In this case then I propose the following: that stress be included in the article with citations from reputable research papers. My proposed edit is as follows:

Stress

Recent research indicates that prolonged stress can be an underlying cause of Metabolic syndrome by upsetting the hormonal balance of the Hypothalamic-pituitary-adrenal axis (HPA-axis). A dysfunctional HPA-axis causes high cortisol levels to circulate which results in raising glucose and insulin levels which cause insulin-mediated effects on adipose tissue, ultimately promoting visceral adiposity, insulin resistance, dyslipidemia and hypertension (metabolic syndrome X) and direct effects on the bone, causing “low turnover” osteoporosis. Cortisol in the presence of relatively high insulin concentrations can promote the deposition of energy and lead to obesity. HPA-axis dysfunction may explain the reported risk indication of abdominal obesity to Cardiovascular disease, type 2 diabetes and stroke. Psychosocial stress is also linked to heart disease.122.107.141.196 (talk) 01:24, 15 December 2009 (UTC)


 * You're quite right that I have not read Kendrick's book, but if the material on stress and metabolic syndrome is verifiable elsewhere, then we'd be better off using those sources. Now if you could put the references in citation templates I can't see why it cannot be included. JFW | T@lk  22:12, 16 December 2009 (UTC)

It was a struggle, but I think it was worth the fight to have Stress added. There seems to be enough evidence that stress is the underlying cause of Metabolic syndrome which results in all the degenerative diseases seen with it. It is a pity that Malcolm Kendrick's book cannot be acknowledged in some way because it truly is a brilliant book. It very well explains how Stress, Metabolic syndrome and heart disease are all tied together. It remains to be seen whether his debunking of the Lipid hypothesis will stand. He does provide a very good case that the cholesterol theory is in error. By adding to this article new important information, it represents the best of what Wiki and an obscure IP editor can achieve (such as myself) with the inspired writings of Dr Kendrick.122.107.141.196 (talk) 08:57, 18 December 2009 (UTC)


 * There are enough sources about the subject that sit a lot higher on the WP:MEDRS hierarchy, and hence Kendrick is not a suitable source. It bears remembering that his writings take the format of an opinion piece, and that they are not in fact peer-reviewed. "Debunking" of a hypothesis by a single author without academic credentials is not part of the normal scientific process. There are bags of epidemiological data (e.g. the prospective studies collaboration reports) that provide undisputable support for what you still call the lipid "hypothesis". JFW | T@lk  19:41, 19 December 2009 (UTC)

Overeating no risk factor?
Just a stupid question. I read the list of risk factors and am somewhat puzzled. I just do not understand why overeating is not listed there. Isn't this the primary cause? Obesity is uncommon in free animals. Their instinct makes them stop eating when they had what they need. Free animals need to be quick for survival and not fat and clumsy. So they do not overeat. Would be nice if an expert can explain me what I got wrong or why overeating is not mentioned in the list. Thank you. 178.25.132.88 (talk) 22:02, 6 August 2010 (UTC)
 * Seems to me that overeating would be listed on the risk factors on the obesity page, but here, obesity is listed as the risk factor. Over eating is just a part of the definition of obesity. If you are over eating, but not obese, it may not be a risk factor. Of course, it may not be over eating if you are not obese.72.187.199.192 (talk) 16:42, 24 April 2011 (UTC)

I would say that overeating is not even a medical terminology and even if so, it is not a physical component of the syndrome, it can be one of many causes that lead to the syndrome factors. Metabolic-Syndrome-info (talk) 23:56, 5 July 2011 (UTC)Metabolic-Syndrome-Info.comMetabolic-Syndrome-info (talk) 23:56, 5 July 2011 (UTC)

Is the metabolic syndrome caused by a high fructose, and relatively low fat, low cholesterol diet?
A new paper is accepted an 'in press' with Archives of Medical Science under the above title

We have developed a new hypothesis regarding MetS as a consequence of a high intake in carbohydrates and food with high glycemic index, particularly fructose, and relatively low intake in cholesterol and saturated fat. We support our arguments through animal studies which have shown that exposure of the liver to increased quantities of fructose leads to rapid stimulation of lipogenesis and accumulation of tryglicerides. The adipocytes store triglycerides in lipid droplets, leading to adipocyte hypertrophy. Adipocyte hypertrophy is associated with macrophage accumulation in adipose tissue. An important modulator of obesity-associated macrophage responses in white adipose tissue is the death of adipocytes. Excess exposure to fructose intake determines the liver to metabolize high doses of fructose, producing increased levels of fructose end products, like glyceraldehyde and dihydroxyacetone phosphate, that can converge with the glycolitic pathway. Fructose also leads to increased levels of advanced glycation end products. The macrophages exposed to advanced glycation end products become dysfunctional and, on entry into the artery wall, contribute to plaque formation and thrombosis. More about this soon.Glynwiki (talk) 16:43, 28 October 2010 (UTC)


 * You ought to provide a reference or a DOI so we can evaluate the paper here. JFW | T@lk  12:42, 29 October 2010 (UTC)


 * https://doi.org/10.5114/aoms.2011.20598. Shootquinn (talk) 00:31, 6 November 2021 (UTC)

Measures effective in only a minority of people
"However, one study stated that these potentially beneficial measures are effective in only a minority of people, primarily due to a lack of compliance with lifestyle and diet changes."

I'm still a wikipedia newbie, but this statement took me by surprise when I read it. A lack of compliance with lifestyle and diet changes does not prove the measures were ineffective. The participants who failed to comply fully with lifestyle and diet changes were ineffective. I think more clarification is needed on how the study reached the conclusion that the measures are effective in only a minority of people. Henachoko No Samurai (talk) 16:35, 28 February 2011 (UTC)


 * This is tricky. If they used an intention to treat analysis, they need to look at the "real world" applicability. If a doctor advises a certain lifestyle regimen, a proportion of people will be unable to comply. That means that the overall benefit to the entire group is diluted, but it is more "real-world" than if you selected on compliance. JFW &#124; T@lk  20:31, 28 February 2011 (UTC)

I read the lead and wondered why it didn't actually define the disease. The I read the article and went back to the lead. I noticed that it does, in a subtle way, define the disease. I don't feel that the introduction does a good job summarizing the disease. Maybe something like    "Metabolic syndrome is a suite of diseases that each separately increase your chance of acquiring heart disease and/or diabetes. Together these diseases seem to multiply the likelihood of acquiring heart disease and/or diabetes." —Preceding unsigned comment added by 72.187.199.192 (talk) 16:39, 24 April 2011 (UTC) Yes but it's not a disease. It is a syndrome that includes several components which together can lead to several serious diseases. Metabolic-Syndrome-info (talk) 00:02, 6 July 2011 (UTC)metabolic-syndrome-info.comMetabolic-Syndrome-info (talk) 00:02, 6 July 2011 (UTC)

Fructose pretty clearly seems to be the cause of met s
I haven't been part of this discussion or development of this page, so am reluctant to edit the page without some consensus (been hammered pretty bad doing that). I have found many resources that support fructose being the primary cause of metabolic syndrome. Fat consumption seems to be a minor issue regarding met syndrome, but the Gov't's Dietary Guidelines are incorrect in recommending high carbohydrate, low fat and low cholesterol diets. I have purchased the two most definitive papers that I have found and have posted them in my Dropbox, online. If you want to read the full articles, send me a message/email with your email address. I can't post them here due to the copyright issues, but I see no reason to not share them with a few interested parties. Summaries are online, linked below.

The citations, in sloppy format, are:

1)the role of fructose in the pathogenesis of naFlD and the metabolic syndrome, Lim et al, Nature, April 2010 doi:10.1038/nrgastro.2010.41

2) Fructose: Metabolic, Hedonic, and Societal Parallels with Ethanol, Lustig, J Am Diet Assoc. 2010;110:1307-1321 doi: 10.1016/j.jada.2010.06.008

Jwanderson (talk) 07:22, 21 July 2011 (UTC)


 * Sloppy indeed. The first citation is not from Nature but from Nature Rev Gastroenterol Hepatol. There is certainly data to support this assertion, but there is insufficient consensus to label this as WP:TRUTH. You are probably correct that replacing fat with carbohydrate may be harmful, and I am sure these guidelines will soon be amended. JFW &#124; T@lk  11:28, 21 July 2011 (UTC)

2009 Harmonizing the metabolic syndrome: a joint interim statement on the definition of the metabolic syndrome
citation - Circulation. 2009 Oct 20;120(16):1640-5. Epub 2009 Oct 5. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Link - http://circ.ahajournals.org/content/120/16/1640.long

This article represents the outcome of a meeting between several major organizations in an attempt to unify criteria. It was agreed that there should not be an obligatory component, but that waist measurement would continue to be a useful preliminary screening tool. Three abnormal findings out of 5 would qualify a person for the metabolic syndrome

Joint Scientific Statement Harmonizing the Metabolic Syndrome Table 1. Criteria for Clinical Diagnosis of the Metabolic Syndrome

Elevated waist circumference* Population- and country-specific definitions

Elevated triglycerides (drug treatment for elevated triglycerides is an alternate indicator†) ≥150 mg/dL (1.7 mmol/L)

Reduced HDL-C (drug treatment for reduced HDL-C is an alternate indicator†) <40 mg/dL (1.0 mmol/L) in males; <50 mg/dL (1.3 mmol/L) in females

Elevated blood pressure (antihypertensive drug treatment in a patient with a history of hypertension is an alternate indicator) Systolic ≥130 and/or diastolic ≥85 mm Hg

Elevated fasting glucose‡ (drug treatment of elevated glucose is an alternate indicator) ≥100 mg/dL (5.6 mmol/L)

HDL-C indicates high-density lipoprotein cholesterol. †The most commonly used drugs for elevated triglycerides and reduced HDL-C are fibrates and nicotinic acid. A patient taking 1 of these drugs can be presumed to have high triglycerides and low HDL-C. High-dose ω-3 fatty acids presumes high triglycerides. ‡Most patients with type 2 diabetes mellitus will have the metabolic syndrome by the proposed criteria — Preceding unsigned comment added by 81.155.49.164 (talk) 17:40, 19 November 2012 (UTC)
 * It is recommended that the IDF cut points be used for non-Europeans and either the IDF or AHA/NHLBI cut points used for people of European origin until more data are available.

simpletropicalsmoothie?
This is not a great citation for information on diabetes, hence the reversion. A little suspicious too. [[~ [[User:juanTamad|juanTamad] (talk) 07:32, 27 August 2015 (UTC)

External Link to stanford does not work
This site can’t be reached

ppap21.stanford.edu’s server DNS address could not be found.

ERR_NAME_NOT_RESOLVED — Preceding unsigned comment added by Aseemseth (talk • contribs) 09:12, 19 April 2016 (UTC)

External links modified (January 2018)
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reversion of my edit concerning research accuracy
hello wikipedians, I edited then had my edit reverted so I undid it. In the section where I edited "People with schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder with psychotic symptoms, drug-induced psychosis or borderline personality disorder who take antipsychotic medication have higher rates of metabolic syndrome. " the cited research does not support 1) a concept of predisposition (despite how fashionable this may be), 2) exclusion of borderline, or 3) any evidence for higher rates of metabolic syndrome among those not taking antipsychotic medication. The topic is quite controversial given findings that drug manufacturers hid the relation of antipsychotics to diabetes, the neglect of health concerns for people with psychiatric diagnosis, and stereotypes of people as sedentary and poor eaters. I'm open to discussion on this but I just don't see the previous version warranted by the research. The idea that diabetes, which results from metabolic syndrome, is somehow a predisposition genetically of people which schizophrenia diagnosis seems especially egregious for an encyclopedia claiming to be evidence based. thanks.
 * Responded on the user's talk page, here. --Zefr (talk) 14:20, 6 August 2018 (UTC)

Racial prejudice in diagnosis?
Reversion of this edit - and the WP:OR opinion in the content by - cannot be supported by a WP:MEDRS review. Reverting again and inviting discussion per WP:BRD. --Zefr (talk) 17:49, 18 April 2019 (UTC)

I have cited the source I pulled this information from. I am not coming up with this on my own, this is research done an accountable social scientist. The notion that racial prejudice exists within diagnosing is not my own opinion it is an actual fact, which, again, I cited in my post. Please allow me to post this. — Preceding unsigned comment added by SwMessand (talk • contribs) 14:46, 23 April 2019 (UTC)

Why is there not mention that antipsychotic drugs cause metabolic syndrome?
The evidence is not just ample it's overwhelming. I am not going to post it here, as I 'll leave others to do the edits who are more well versed in wiki editing. One google scholar or google search with keywords metabolic syndrome and antipsychotics should suffice. Just as a token, "Metabolic syndrome is a leading cause of morbidity and mortality in patients with schizophrenia, with a prevalence rate double that of nonpsychiatric populations. Given the amount of evidence suggesting a link between atypical antipsychotic medications and metabolic syndrome, several agencies have recommended regular clinical monitoring of weight, symptoms of hyperglycemia, and glucose in chronically medicated patients with schizophrenia." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4105724/ Please do not delete this entry, If you do I will ask for you to be penalised. It's not a rant, but a valid section that is completely missing from the article, together with research. --2A02:587:391E:AC00:BD5A:47FB:6383:5641 (talk) 08:06, 19 April 2020 (UTC)
 * The report provided above is outdated (by 11 years) and published in a low-quality journal, so was and remains unreliable. Google isn't the place to search for information on this topic, but rather the medical review literature provides the answer: This 2018 review of reviews is one among other sources indicating no cause-and-effect relationship between metabolic syndrome and psychotic disorders or drugs: "there is insufficient evidence to clearly answer the questions on the efficacy and potential harms of antipsychotic polypharmacy". Zefr (talk) 15:18, 19 April 2020 (UTC)
 * There is a clear cause and effect relationship between atypical antipsychotics (aaps) and metabolic syndrome. It's widely reported in the psychiatric literature. It should be obvious also due to the adverse metabolic effects of aaps weight gain and diabetic predisposition, these are even mentioned on the leaflets for these types of medicines. The review you posted deals with polypharmacy, and it only points out to the fact that since polypharmacy is not widely practised, there is, obviously, insufficient evidence on it. I am not well versed on wikipedia to continue with edits, or, for that matter, to know the etiquette of talk pages, but I think I am making a contribution for leaving this clearly important information here for editors to pick up on. 2A02:587:390C:DE00:D024:12DB:453:5344 (talk) 01:45, 12 May 2020 (UTC)
 * I am just going to add a link https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Quetiapine-(Seroquel), to the highly regarded and accurate National Alliance on Mental Illness that delineates some methods to decrease the chances of metabolic syndrome while on antipsychotics, for anyone interested in this and for a future addition to the entry. Wish I could do the edits, but I hope at some point someone will pick up on this. 2A02:587:390C:DE00:E09A:3019:4BE0:D5D6 (talk) 15:07, 6 June 2020 (UTC)