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The metabolic syndrome is defined by five components, namely, abdominal obesity, elevated triglycerides, reduced HDL-cholesterol, elevated blood glucose and elevated blood pressure.The patient has the syndrome if 3 or more of these components are abnormal.In the United States, about one-third of adult men and women have this syndrome.With the rapid socioeconomic development in Asia and the resultant changes in lifestyle, the metabolic syndrome will become a major cause of morbidity and mortality in Asia.Our observations in the Hong Kong Cardiovascular Risk Factor Prevalence Study (CRISPS) suggest that the metabolic syndrome is a process in which obesity develops first, followed by elevated triglycerides and/or reduced HDL; hypertension and diabetes then develop later.