In 1988, Gerald Reaven coined the term Syndrome X to describe a complex of metabolic abnormalities, including glucose intolerance, hypertriglyceridemia and reduced levels of HDL-cholesterol, present in individuals at increased risk for cardiovascular disease [1]. Since then, attempts to quantify cardiovascular disease risk have led to the development of clinical criteria for the diagnosis of this syndrome, now known as the metabolic syndrome or insulin resistance syndrome. Although these criteria continue to evolve, those put forth by the National Cholesterol Education Program (NCEP), World Health Organization (WHO), European Group for the Study of Insulin Resistance (EGIR), International Diabetes Federation (IDF) and American Association of Clinical Endocrinologists (AACE), all include hyperglycemia, hypertriglyceridemia, low HDL-cholesterol and hypertension (reviewed in [2)] (Table 1). It is clear now that the metabolic syndrome is associated with many diseases in addition to cardiovascular disease. These include cholesterol gallstones, non-alcoholic fatty liver disease, which ranges from benign steatosis to non-alcholic steatohepatitis (NASH), polycystic ovary disease (PCOS) and neurodegenerative disease.