Abbas Tavakolian Arjmand is an Assistant Professor of Endocrinology & Metabolism at Shahrood University, Iran.


The galloping incidence and the alarming prevalence of metabolic syndrome ( MbS) has put the human life on the edge of a certain catastrophe. Despite the full-blown epidemic presentation and ongoing and ever-expanding list of clinical and biochemical manifestations of the syndrome, not much have been logically addressed with regard to a comprehensive pathogenesis and an integrated etiology. We, all, have heard the tale of examining a huge elephant in the dark. We would like to open a small but sun-view window and shed a faint beam of light onto this perplexing issue and puzzle out the neglected pieces of a semi set picture and carry the current concepts regarding MbS one big step further. We believe that, this human health tsunami is not merely a metabolic disorder, but also a real chaos at the level of molecular biology and inter-cellular dialogue; a state of generalized cell swelling, cell senescence, chronic oxidative stress, and derailed tissue remodeling due to diverse unusual tissue growth factors expressions. Opposite to common concept of over- feeding and obesity as the initiating factor of metabolic syndrome, we would suggest that a world-wide ubiquitous environmental insult has led to a state of profound signal-receptor mal-engagement and misunderstanding. A true syndromic disorder which is unequivocally tied up to a strange acquired insulin resistance state dramatically emerged in late 1980s. The centripetal obesity of metabolic syndrome is the result of this primary insulin resistance and compensatory hyperinsulinemia, not simply the cause of it. At the end, an all-embracing environmental etiologic factor will be hinted as a novel pathogenesis.