Metabolic syndrome is not a single disease, but a combination of factors that often occur together: abdominal fat, high blood pressure, high blood glucose, high triglycerides and low HDL. This combination increases the risk of type 2 diabetes, cardiovascular disease and metabolic fatty liver disease.
Commonly used criteria
A widely used definition identifies metabolic syndrome when at least 3 of 5 features are present:
- increased waist circumference – approximately above 102 cm in men and above 88 cm in women, with thresholds that may vary by population;
- triglycerides of 150 mg/dL or above, or treatment for high triglycerides;
- low HDL – below 40 mg/dL in men or below 50 mg/dL in women;
- blood pressure of 130/85 mmHg or above, or blood pressure medication;
- fasting glucose of 100 mg/dL or above, or treatment for high glucose.
Not all guidelines use identical thresholds, but the practical message is the same: when these factors accumulate, cardiometabolic risk increases.
Why is it linked to insulin resistance?
Insulin resistance means the body needs more insulin to control blood glucose. Over time, this may be associated with high glucose, high triglycerides, abdominal fat and high blood pressure. For the full explanation, read the article on insulin resistance.
Which tests are useful?
- fasting glucose and HbA1c – for prediabetes or diabetes;
- lipid profile – total cholesterol, LDL, HDL and triglycerides;
- ALT, AST, GGT – for liver assessment;
- creatinine, eGFR and urine albumin-to-creatinine ratio – especially with diabetes or hypertension;
- blood pressure and waist circumference – simple but very important measurements.
You can use the online test interpretation service if you have results but do not know how they relate to one another.
How is it treated?
Treatment focuses on reducing overall risk rather than a single number. It usually includes weight loss if needed, nutrition providing enough fibre and protein, physical activity, sleep, stopping smoking and treatment for blood pressure, cholesterol or glucose when recommended by the doctor.
A Mediterranean-style diet and a personalised nutrition plan may help because they address weight, glucose and the lipid profile at the same time.
