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The metabolic syndrome: current perspective
Since the 1998 Banting lecture, a number of new candidates have been recognized for the metabolic syndrome/insulin resistance syndrome/syndrome “X”.  These additional candidates have included small dense LDL and a group of novel risk factors including elevated CRP levels, PAI-1 and fibrinogen.  Other investigators have noted that insulin resistance occurs in women with polycystic ovarian syndrome and some authors are now making an association of insulin resistance with non-alcoholic fatty liver disease.  Note that in this more recent review, Professor Reaven acknowledges the importance of visceral adiposity.  
1. Reaven G. Syndrome X:  10 years after. Drugs. 1999;58(suppl 1):19-20.