Initially, your doctor will ask about your symptoms and medical history. A physical exam will be done.

Diagnotistic Criteria

The National Cholesterol Education Program (NCEP), which is part of the National Heart, Lung, and Blood Institute at the National Institutes of Health, published criteria for diagnosing metabolic syndrome in their Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)—also known as ATP III.

According to the report, you have metabolic syndrome if you have at least three out of five of the following conditions:

  • Central obesity—This occurs when extra fat tissue is "central," found in the waist area, thus having greater metabolic consequences.
    • In men, defined as waist measurement greater than or equal to 35 inches (90 cm)
    • In women, defined as waist measurement greater than or equal to 31 inches (80 cm )
  • Glucose intolerance—This occurs when your body is not able to efficiently convert carbohydrates (the energy source found in foods such as fruits, vegetables, and starches) into energy for the body to use.
    • Defined by a fasting glucose level greater than or equal to 100 mg/dL (5.6 mmol/L)
  • Insulin resistance—This occurs when your body is unable to respond to and use the insulin it produces—often a feature of type 2 diabetes.
  • Unhealthy cholesterol levels—Called dyslipidemia, this is happens when the amount of lipids (or fats) circulating in the blood is higher or lower then normal, including
    • Elevated triglycerides—Triglycerides are a kind of fat found in your blood .
      • Fasting blood triglycerides greater than or equal to 150 mg/dL (1.6 mmol/L)
    • Low HDL—HDL stands for high-density lipoprotein, which breaks down and removes cholesterol from the body. It is sometimes referred to as the “good cholesterol.”
      • In men, defined as LDL levels less than 40 mg/dL (1.0 mmol/L)
      • In women, defined as LDL levels less than 50 mg/dL (1.3 mmol/L)
  • High blood pressure
    • Defined as a blood pressure greater than or equal to 130/85 mmHg.

Diagnostic Tests

There are a number of non-laboratory tests (ie, those that can be done in your doctor’s office) and laboratory tests that your doctor may want to perform, including:

Non-Laboratory Tests

  • Waist circumference—Using a regular tape measure, your doctor will measure around your waist.
  • BMI—This is a measure of your weight in relation to your height used to determine if you are overweight.
  • Weight
  • Blood pressure

Laboratory Tests

Glucose tests—These tests check your blood sugar levels and make sure they are within normal range. There are a few ways that this can be accomplished:

  • Fasting glucose tests—Your doctor will ask you to fast (not eat) after dinner the night before the test. The next morning, he or she will take a blood sample from your arm to test it for glucose levels.
  • Post-prandial (after a meal) glucose test—Your doctor will test a sample of your blood right after a meal.
  • Glucose tolerance test (GTT)—Your doctor will measure how well your body can respond to a glucose (sugar) load. First, a blood sample will be taken from your arm and tested for glucose levels before anything is eaten (to establish a comparison base). Then, you will drink a liquid that has glucose (sugar) in it. Blood will then be taken and tested at timed intervals to see how your body deals with the glucose in the blood.

Tests for cholesterol levels —These tests are also called lipid profile tests and are often done all together. Tests for these types of cholesterol can all be done by your doctor. He or she will test a sample of your blood taken from the arm or a fingerstick.

  • Total cholesterol
  • Serum triglyceride levels—Triglycerides are a kind of fat found in your blood.
  • LDL cholesterol levels—LDL stands for low-density lipoprotein and is the “bad” cholesterol.
  • HDL cholesterol levels test

Associated Diseases

Patients with the metabolic syndrome may also have the following diseases: