Metabolic syndrome

Last reviewed: 29 Oct 2022
Last updated: 22 Mar 2022

Summary

Definition

History and exam

Key diagnostic factors

  • hypertension
  • increased BMI
  • increased waist and hip circumferences
More key diagnostic factors

Other diagnostic factors

  • type 2 diabetes mellitus (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
Other diagnostic factors

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
More risk factors

Diagnostic investigations

1st investigations to order

  • fasting blood glucose
  • fasting triglycerides
  • fasting total cholesterol
  • fasting HDL-cholesterol
  • fasting LDL-cholesterol
More 1st investigations to order

Investigations to consider

  • oral glucose tolerance test (OGTT)
  • serum BUN and creatinine
  • aminotransferases
  • urinalysis
  • thyroid-stimulating hormone (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
More investigations to consider

Treatment algorithm

ONGOING

all patients

Contributors

Authors

Panagiotis Anagnostis, MD, PhD

Endocrinologist

Department of Internal Medicine

Medical School

Aristotle University of Thessaloniki

Thessaloniki

Greece

Disclosures

PA declares that he has no competing interests.

Acknowledgements

Dr Panagiotis Anagnostis would like to gratefully acknowledge Professor Faidon Harsoulis, a previous contributor to this topic.

Disclosures

FH declared that he had no competing interests.

Peer reviewers

Kent Wehmeier, MD

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.

Scott Grundy, MD, PhD

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 topic. 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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