Metabolic Syndrome

What is metabolic syndrome?

A cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus, which occur together more often than by chance alone.

The risk factors include

·        raised blood pressure,

·   dyslipidemia (raised triglycerides and lowered high-density lipoprotein cholesterol),

·        raised fasting glucose,

·        central obesity.

How to diagnose?

Various diagnostic criteria have been proposed by different organizations over the past decade. Most recently, these have come from the

·       International Diabetes Federation

·       American Heart Association/National Heart, Lung, and Blood Institute.

The main difference concerns the measure for central obesity, with this being an obligatory component in the International Diabetes Federation definition, lower than in the American Heart Association/National Heart, Lung, and Blood Institute criteria, and ethnic specific.

Three abnormal findings out of 5 would qualify a person for the metabolic syndrome.

	Measure	Categorical Cut Points
1	Elevated waist circumference*	Population- and country-specific definitions
2	Elevated triglycerides (drug treatment for elevated triglycerides is an alternate indicator†)	≥150 mg/dL (1.7 mmol/L)
3	Reduced HDL-C (drug treatment for reduced HDL-C is an alternate indicator†)	<40 mg/dL (1.0 mmol/L) in males; <50 mg/dL (1.3 mmol/L) in females
4	Elevated blood pressure (antihypertensive drug treatment in a patient with a history of hypertension is an alternate indicator)	Systolic ≥130 and/or diastolic ≥85 mm Hg
5	Elevated fasting glucose‡ (drug treatment of elevated glucose is an alternate indicator)	≥100 mg/dL

(Circulation. 2009;120:1640-1645.)