From the Guidelines
The diagnostic criteria for Metabolic Syndrome are based on the presence of at least three of the following five components: central obesity, elevated triglycerides, reduced HDL cholesterol, elevated blood pressure, and elevated fasting glucose.
Diagnostic Criteria
- Central Obesity: population- and country-specific definitions, with waist circumference thresholds of >102 cm for men and >88 cm for women in Europid populations 1
- Elevated Triglycerides: ≥150 mg/dL (1.7 mmol/L) 1
- Reduced HDL Cholesterol: <40 mg/dL (1.0 mmol/L) in males and <50 mg/dL (1.3 mmol/L) in females 1
- Elevated Blood Pressure: systolic ≥130 mmHg and/or diastolic ≥85 mmHg 1
- Elevated Fasting Glucose: ≥100 mg/dL 1 These criteria are based on the harmonized definition proposed by the International Diabetes Federation, National Heart, Lung, and Blood Institute, American Heart Association, and other organizations 1.
Key Considerations
- The presence of three or more of these components is required for a diagnosis of Metabolic Syndrome 1
- The diagnosis is of greatest importance in non-diabetic subjects as an indicator of increased risk of developing type 2 diabetes and cardiovascular disease (CVD) 1
- Lifestyle changes, such as weight loss and increased physical activity, are the primary management strategy for Metabolic Syndrome, with additional drug treatment as needed for elevated blood pressure, dyslipidemia, and hyperglycemia 1
From the Research
Diagnostic Criteria for Metabolic Syndrome
The diagnostic criteria for metabolic syndrome include a combination of risk factors, with different organizations proposing slightly varying criteria. The most widely accepted criteria are those proposed by the World Health Organization (WHO), the European Group for the Study of Insulin Resistance (EGIR), and the National Cholesterol Education Program--Third Adult Treatment Panel (NCEP-ATP III) 2.
Key Components of Metabolic Syndrome
The core components of metabolic syndrome include:
- Obesity
- Insulin resistance
- Dyslipidemia
- Hypertension
These components are commonly agreed upon by different organizations, although the specific criteria and cutoff values may vary 2, 3.
Specific Diagnostic Criteria
According to the study by 3, the diagnostic criteria for metabolic syndrome include at least three of the following five medical conditions:
- Abdominal obesity
- High blood pressure
- Abnormal high fasting plasma glucose
- Elevated serum triglycerides
- Low HDL (high-density cholesterol) level
The specific cutoff values for these conditions are:
- Fasting glucose ≥ 100 mg/dL or type 2 diabetes receiving drug therapy for hyperglycemia
- High blood pressure ≥ 130/85 mm Hg or high blood pressure receiving drug therapy
- Triglycerides ≥ 150 mg/dL or treatment for plasma hyper-triglyceride value
- HDL-C < 40 mg/dL in men and < 50 mg/dL in women or if under therapy for reduced HDL-C levels
- Waist circumference ≥ 102 cm in men and ≥ 88 cm in women
Comparison of Diagnostic Criteria
A comparative analysis of different diagnostic criteria for metabolic syndrome found that the prevalence of the syndrome ranged from 8.6% to 44.5% depending on the criteria used 4. The study also found that the ability to correctly identify individuals at high cardiovascular risk was limited, with a maximum sensitivity of 60%.
Associated Risk Factors
In addition to the core components of metabolic syndrome, other risk factors have been associated with the syndrome, including:
- Waist to hip ratio
- High density lipoprotein dysfunction
- Small dense low density lipoprotein
- Postprandial hypertriglyceridaemia
- Lipoprotein (a)
- Uric acid
- Liver function tests
- Prothrombotic factors
- Cytokines
- Adipokines
- Vitamin D
- Arterial stiffness
- Renal dysfunction
- Nephrolithiasis
- Polycystic ovary syndrome
- Obstructive sleep apnea 5.