Metabolic Syndrome Diagnosis

Medical history
Your primary care physician or family doctor can help you exclude or confirm a metabolic syndrome diagnosis. To begin, your doctor will ask you questions about your personal and family medical histories. Be sure to tell your doctor if you take medications to treat blood pressure, blood sugar, cholesterol or triglyceride levels, as this information is critical for diagnosis. Although your doctor is not typically looking for "metabolic syndrome," the label may apply if you experience three or more of the traits associated with this condition.

To be diagnosed with metabolic syndrome, you must exhibit at least three out of five of the following:

1. Higher than normal blood pressure – A blood pressure reading of 130/85 or higher is a possible trait of metabolic syndrome. If only one of your two blood pressure numbers is high, this qualifies as a possible sign of metabolic syndrome.
   
   
2. Higher than normal fasting blood sugar – Blood sugar (glucose) levels higher than 100 mg/dL are a component of metabolic syndrome.
   
   
3. Higher than normal triglyceride levels - Triglycerides are a type of fat found in the blood. A triglyceride level of 150 mg/dL or higher is a component of metabolic syndrome.
   
   
4. Large waistline –Your doctor will measure your waist to determine whether you are experiencing abdominal obesity, or excess fat around the waist. A waist measurement of 35 inches or more for women and 40 inches or more for men is a component of metabolic syndrome and indicates an increased risk for heart disease and other health problems.
   
   
5. Lower than normal levels of HDL cholesterol – High density lipoprotein is considered “good” cholesterol because it lowers chances of heart disease. An HDL cholesterol level less than 50 mg/dL for women and less than 40 mg/dL for men is a component of metabolic syndrome. This condition is usually followed by increased levels of LDL (low density lipoprotein) which is considered the “bad” cholesterol and increases chances of heart disease.

Medical exams
Doctors first suspect metabolic syndrome in cases of central/abdominal obesity and a sedentary lifestyle, but both laboratory and non-laboratory tests are important in establishing the diagnosis. The diagnosis of metabolic syndrome is based on the results of a physical exam and blood tests. Tests used to diagnose metabolic syndrome include:

Blood pressure – This test is used to confirm or exclude cases of hypertension.

BMI (body mass index) – BMI is an alternate measure of obesity used by many doctors that compares average weight to height ratios. BMI is calculated by taking: (Weight in pounds X 705) / (height in inches squared). An adult with a BMI greater than 30 is considered obese. This calculation does not, however, describe location of excess weight on the body, another important factor for metabolic syndrome diagnosis.

Weight – Doctors take your weight in order to calculate body mass index and to calculate possible obesity.

Waist circumference – This measurement is use to document possible abdominal obesity. Excess fat around the waist is one component of metabolic syndrome.

Laboratory tests
Doctors often recommend other laboratory tests for both diagnosing metabolic syndrome and to provide them with additional information. Recommended tests include:

C-peptide – This test is a reliable indicator of endogenous insulin production.

DLDL – This test is a direct measurement of low density lipoprotein.

Glucose test - The goal of glucose testing is to determine whether an impaired response to glucose results in elevated blood glucose levels, or not. Usually doctors order a fasting glucose test but, in some cases, a doctor may also order a post prandial glucose test (after a meal) or a glucose tolerance test where several glucose tests that are taken before and at timed intervals after a glucose challenge.

hs-CRP - A measure of low levels of inflammation that may be tested as part of an evaluation of cardiac risk.

Insulin test - The fasting insulin test is considered too variable to be clinically useful in diagnosing metabolic syndrome but, if measured, will usually be elevated in those affected.

Lipid profile - This test measures HDL, LDL, triglycerides, and VLDL.

Microalbumin - This test is used to help monitor diabetes and is an early indicator of kidney disease.

SdLDL – Used to measure the number of small dense low-density lipoprotein molecules

It’s possible to prevent or delay metabolic syndrome, mainly with lifestyle changes. But successfully controlling metabolic syndrome takes long term effort and cooperation with your doctors. Read on to learn more about how you can change your lifestyle as well as the other treatment options for metabolic syndrome, including how to manage a metabolic diet.