Although the metabolic syndrome has existed in various forms and definitions for more than eight decades, only in the past 5 years has real controversy about its definition and significance emerged. 1 The main controversy was that the syndrome had had too many definitions and there was a lack of clarity about its role and value in clinical practice. And it is fair to say, with exception, 2 that most of the published reports indicate that the syndrome does not predict cardiovascular events or disease progression any better than the sum of its components. 3, 4 The relative value in predicting type 2 diabetes remains uncertain. 5