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Diagnosis of Metabolic Syndrome

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Diagnostic Criteria

The National Cholesterol Education Program offers these criteria for diagnosing metabolic syndrome. With these criteria, you have metabolic syndrome if you have 3 of the 5 following conditions:

Central Obesity

Central obesity occurs when extra fat tissue is concentrated in the waist area. This has been found to have greater metabolic consequences than when fat is concentrated in the hips and thighs. Central obesity may be defined as:

  • In men—waist measurement greater than or equal to 40 inches (102 cm)
  • In women—waist measurement greater than or equal to 35 inches (89 cm)

There is some variation in this guideline with ethnicity in relation to overall size.

Elevated Fasting Blood Sugar

When your body cannot appropriately control the levels of sugar in the blood, impaired fasting glucose occurs. This is defined as a fasting glucose level greater than or equal to 100 mg/dL (5.6 mmol/L). People previously diagnosed with type 2 diabetes also meet this criterium.

Elevated Blood Pressure

Elevated blood pressure is defined as a blood pressure greater than or equal to 130/85 mm Hg.

Elevated Triglycerides

Triglycerides are a kind of fat found in your blood. This is defined as fasting blood triglycerides greater than or equal to 150 mg/dL (1.6 mmol/L).

Reduced HDL

HDL stands for high-density lipoprotein. This breaks down and removes cholesterol from the body. It is sometimes referred to as the good cholesterol. This is defined as:

  • In men—HDL levels less than 40 mg/dL (1.0 mmol/L)
  • In women—HDL levels less than 50 mg/dL (1.3 mmol/L)

Diagnostic Tests

There are a number of tests that your doctor may do. Examples include:

Tests Done in Your Doctor's Office
  • Waist circumference—a measurement around your hips and belly button
  • Blood pressure
Lab Tests
Fasting Glucose Test

Your doctor will ask you to fast (not eat) after dinner the night before the test. The next morning, a blood sample will be tested for glucose levels.

Tests for Cholesterol Levels

These tests are also called lipid profile tests. After fasting, a blood sample will be taken to check for levels of:

  • Total cholesterol
  • Triglycerides
  • LDL cholesterol—low-density lipoprotein (bad cholesterol)
  • HDL cholesterol—high-density lipoprotein (good cholesterol)

Revision Information

  • Deen D. Metabolic Syndrome: time for action. Am Fam Physician. 2004;69(12):2875-2882.

  • Gami AS, Witt BJ, Howard DE, et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007;49(4):403-414.

  • Grundy SM. Metabolic syndrome: a multiplex cardiovascular risk factor. J Clin Endocrinol Metab. 2007;92(2):399-404.

  • Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome. Circulation. 2005;112(17):2735-2752.

  • How is metabolic syndrome diagnosed? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/ms/diagnosis. Updated November 6, 2015. Accessed June 7, 2016.

  • Metabolic syndrome in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113812/Metabolic-syndrome-in-adults. Updated March 11, 2016. Accessed September 23, 2016.

  • Reaven GM. The metabolic syndrome: requiescat in pace. Clin Chem. 2005;51(6):931-938.

  • Symptoms and diagnosis of metabolic syndrome. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/More/MetabolicSyndrome/Symptoms-and-Diagnosis-of-Metabolic-Syndrome%5FUCM%5F301925%5FArticle.jsp#.V1bPuk2FMdU. Updated November 20, 2014. Accessed June 7, 2016.

  • Tan CE, Ma S, Wai D, Chew SK, Tai ES. Can we apply the National Cholesterol Education program Adult Treatment Panel Definition of the metabolic syndrome to Asians? Diabetes Care. 2004;27(5):1182-1186.

  • Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): Executive Summary. National Heart, Lung & Blood Institute, National Institutes of Health website. Available at: http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3xsum.pdf. Accessed June 7, 2016.