Metabolic Syndrome and Robustness Tradeoffs

  1. Hiroaki Kitano123,
  2. Kanae Oda4,
  3. Tomomi Kimura24,
  4. Yukiko Matsuoka5,
  5. Marie Csete6,
  6. John Doyle7 and
  7. Masaaki Muramatsu4
  1. 1Sony Computer Science Laboratories, Inc., Tokyo, Japan
  2. 2Systems Biology Institute, Tokyo, Japan
  3. 3Keio University, Tokyo, Japan
  4. 4Medicala Research Institute, Tokyo Medical and Dental University, Tokyo, Japan
  5. 5ERATO-SORST Kitano Symbiotic Systems Project, Japan Science and Technology Agency, Tokyo, Japan
  6. 6Anesthesiology Department, Emory University, Atlanta, Georgia
  7. 7Control and Dynamical Systems, California Institute of Technology, Pasadena, California
  1. Address correspondence and reprint requests to Hiroaki Kitano, Sony Computer Science Laboratories, Inc. 3-14-13, Higashi-Gotanda, Shinagawa, Tokyo 141-0022 Japan. E-mail: kitano{at}


The metabolic syndrome is a highly complex breakdown of normal physiology characterized by obesity, insulin resistance, hyperlipidemia, and hypertension. Type 2 diabetes is a major manifestation of this syndrome, although increased risk for cardiovascular disease (CVD) often precedes the onset of frank clinical diabetes. Prevention and cure for this disease constellation is of major importance to world health. Because the metabolic syndrome affects multiple interacting organ systems (i.e., it is a systemic disease), a systems-level analysis of disease evolution is essential for both complete elucidation of its pathophysiology and improved approaches to therapy. The goal of this review is to provide a perspective on systems-level approaches to metabolic syndrome, with particular emphasis on type 2 diabetes. We consider that metabolic syndromes take over inherent dynamics of our body that ensure robustness against unstable food supply and pathogenic infections, and lead to chronic inflammation that ultimately results in CVD. This exemplifies how trade-offs between robustness against common perturbations (unstable food and infections) and fragility against unusual perturbations (high–energy content foods and low–energy utilization lifestyle) is exploited to form chronic diseases. Possible therapeutic approaches that target fragility of emergent robustness of the disease state have been discussed. A detailed molecular interaction map for adipocyte, hepatocyte, skeletal muscle cell, and pancreatic β-cell cross-talk in the metabolic syndrome can be viewed at


  • This article is based on a presentation at a symposium. The symposium and the publication of this article were made possible by an unrestricted educational grant from Servier.

    • Accepted April 12, 2004.
    • Received February 23, 2004.
| Table of Contents