Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • hypertension
  • increased BMI
  • increased waist and hip circumferences

Other diagnostic factors

  • type 2 DM
  • nonalcoholic fatty liver disease
  • angina
  • claudication
  • sleep disturbance, excessive daytime sleepiness, snoring, gasping breaths
  • hyperuricemia
  • menstrual disturbances
  • abdominal pain
  • corneal arcus and xanthelasma
  • hirsutism
  • acanthosis nigricans
  • acne
  • hepatomegaly

Risk factors

  • obesity
  • insulin resistance
  • physical inactivity
  • high-saturated-fat diet
  • high-carbohydrate diet
  • excess alcohol consumption
  • increasing age
  • ethnicity
  • smoking
  • positive family history
  • polycystic ovary syndrome (PCOS)
  • corticosteroids
  • antipsychotics
  • lipodystrophy
  • HIV infection

Diagnostic investigations

1st investigations to order

  • fasting blood glucose
  • fasting triglycerides
  • fasting total cholesterol
  • fasting HDL-cholesterol
  • fasting LDL-cholesterol
Full details

Investigations to consider

  • oral glucose tolerance test
  • serum BUN and creatinine
  • aminotransferases
  • urinalysis
  • TSH
  • free T4
  • abdominal ultrasound
  • ECG
  • CXR
  • serum total and free testosterone
  • serum dehydroepiandrosterone sulfate
  • androstenedione
  • serum sex hormone binding globulin
  • serum luteinizing and follicle-stimulating hormones
  • prolactin
  • ultrasound of ovaries
  • serum uric acid
Full details

Treatment algorithm

ONGOING

Contributors

Authors VIEW ALL

Endocrinologist

Department of Internal Medicine

Medical School

Aristotle University of Thessaloniki

Thessaloniki

Greece

Disclosures

PA declares that he has no competing interests.

Professor of Endocrinology

Department of Internal Medicine

Medical School

Aristotle University of Thessaloniki

Thessaloniki

Greece

Disclosures

FH declares that he has no competing interests.

Peer reviewers VIEW ALL

Chief

Division of Endocrinology

Program Director

Endocrinology Fellowship

Division of Endocrinology, Diabetes and Metabolism

University of Florida College of Medicine

Jacksonville

FL

Disclosures

KW declares that he has no competing interests.

Professor

Center for Human Nutrition

The University of Texas Southwestern Medical Center

Dallas

TX

Disclosures

SG is an author of several references cited in this monograph. SG has consulted for several companies (Pfizer, AstraZeneca, Merck, Merck Schering Plough, Lilly, Abbott, Sanofi-Aventis, GlaxoSmithKline) that produce lipid-lowering drugs.

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