How Is Metabolic Syndrome Diagnosed?

The diagnosis of metabolic syndrome is based on the results of a physical exam and blood tests. To be diagnosed with metabolic syndrome, you must have at least three out of five of the following risk factors:

• A large waistline. This means that you carry excess weight around your waist (abdominal obesity). Your doctor will measure your waist to determine whether you have abdominal obesity. 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. A large waistline also is called “having an apple shape.”
• A higher than normal triglyceride level, or you’re on medicine to treat high triglycerides. 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.
• A lower than normal level of HDL cholesterol (high-density lipoprotein cholesterol), or you’re on medicine to treat low HDL. HDL is considered “good” cholesterol because it lowers your 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.
• Higher than normal blood pressure, or you’re on medicine to treat high blood pressure. A blood pressure of 130/85 or higher is a component of metabolic syndrome. If only one of your two blood pressure numbers is high, it’s still a risk factor for metabolic syndrome.
• Higher than normal fasting blood sugar (glucose), or you’re on medicine to treat high blood sugar. A normal fasting blood sugar is less than 100 mg/dL. Fasting blood sugar between 100 and 125 mg/dL is considered prediabetes. Fasting blood sugar of 126 mg/dL or higher is considered diabetes. A fasting blood sugar of 100 mg/dL or higher (prediabetes or diabetes) is a component of metabolic syndrome.

About 85 percent of people who have type 2 diabetes (the most common type) also have metabolic syndrome. These people have a much higher risk for heart disease than the 15 percent of people who have type 2 diabetes, but don’t have metabolic syndrome.