Approach

Typically, patients are asymptomatic and metabolic syndrome is detected on routine blood tests or physical examination for other causes. Suspicion should be raised in patients with coronary artery disease (CAD) or with a family history of CAD or type 2 diabetes mellitus (DM). Patients who are older, from an urban area, with a Western lifestyle, or exhibiting certain features such as polycystic ovary syndrome (PCOS) are more susceptible to metabolic syndrome and should be more carefully investigated.

The use of 6 different sets of criteria complicates the diagnosis of metabolic syndrome, as an individual patient can meet one set and not another and those meeting any 2 sets of criteria seem to be at no less risk than those meeting 3. It has been suggested that all coronary vascular disease risk factors should be individually and aggressively treated, and that achieving these goals removes the need for a diagnosis of metabolic syndrome.[54]

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