Diagnosis of Metabolic Syndrome

by Diane A. Safer, PhD Main PageRisk FactorsSymptomsDiagnosisTreatmentScreeningReducing Your RiskTalking to Your DoctorResource GuideEn Espaol (Spanish Version) Initially, your doctor will ask about your symptoms and medical history, and perform a physical exam. Diagnotistic CiteriaThe National Cholesterol Education Program (NCEP), which is part of the National Heart, Lung, and Blood Institute at the National Institutes of Health, published criteria for diagnosing metabolic syndrome in their 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)also known as ATP III. According to the report, you have metabolic syndrome if you have at least three out of five of the following conditions: Central obesityThis occurs when extra fat tissue is "central," found in the waist area, thus having greater metabolic consequences. In men, defined as waist measurement greater than or equal to 35 inches (90 cm)In women, defined as waist measurement greater than or equal to 31 inches (80 cm )Glucose intoleranceThis occurs when your body is not able to efficiently convert carbohydrates (the energy source found in foods such as fruits, vegetables, and starches) into energy for the body to use. Defined by a fasting glucose level greater than or equal to 100 mg/dL (5.6 mmol/L)Insulin resistanceThis occurs when your body is unable to respond to and use the insulin it producesoften a feature of type 2 diabetes. Unhealthy cholesterol levelsCalled dyslipidemia, this is happens when the amount of lipids (or fats) circulating in the blood is higher or lower then normal, including Elevated triglyceridesTriglycerides are a kind of fat found in your blood . Fasting blood triglycerides greater than or equal to 150 mg/dL (1.6 mmol/L)Low HDLHDL stands for high-density lipoprotein, which breaks down and removes cholesterol from the body. It is sometimes referred to as the good cholesterol. In men, defined as LDL levels less than 40 mg/dL (1.0 mmol/L) In women, defined as LDL levels less than 50 mg/dL (1.3 mmol/L) High blood pressureDefined as a blood pressure greater than or equal to 130/85 mmHg. Diagnostic TestsThere are a number of non-laboratory tests (ie, those that can be done in your doctors office) and laboratory tests that your doctor may want to perform, including:

Non-Laboratory TestsWaist circumferenceUsing a regular tape measure, your doctor will measure around your waist. BMIThis is a measure of your weight in relation to your height used to determine if you are overweight. WeightBlood pressureLaboratory TestsGlucose testsThese tests check your blood sugar levels and make sure they are within normal range. There are a few ways that this can be accomplished: Fasting glucose testsYour doctor will ask you to fast (not eat) after dinner the night before the test. The next morning, he or she will take a blood sample from your arm to test it for glucose levels. Post-prandial (after a meal) glucose testYour doctor will test a sample of your blood right after a meal. Glucose tolerance test (GTT)Your doctor will measure how well your body can respond to a glucose (sugar) load. First, a blood sample will be taken from your arm and tested for glucose levels before anything is eaten (to establish a comparison base). Then, you will drink a liquid that has glucose (sugar) in it. Blood will then be taken and tested at timed intervals to see how your body deals with the glucose in the blood. Tests for cholesterol levelsThese tests are also called lipid profile tests and are often done all together. Tests for these types of cholesterol can all be done by your doctor. He or she will test a sample of your blood taken from the arm or a fingerstick.

Total cholesterolSerum triglyceride levelsTriglycerides are a kind of fat found in your blood. LDL cholesterol levelsLDL stands for low-density lipoprotein and is the bad cholesterol. HDL cholesterol levels test References: Deen D. Metabolic Syndrome: time for action. Am Fam Physician. 2004;69:2875-2882. 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;49:403-414. Getting tough with metabolic syndrome. Post Grad Med. Available at: http://www.postgradmed.com/issues/2004/01_04/metabolic_foldout.pdf . Accessed July 28, 2005. Grundy SM. Metabolic syndrome: a multiplex cardiovascular risk factor. J Clin Endocrinol Metab. 2007;92:399-404. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome. Circulation. 2005;112:e285-e290. Metabolic syndrome. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4756 . Accessed July 28, 2005.