Because metabolic syndrome is characterized by the presence of at least three distinct disorders, there are no symptoms specific to this condition. However, the National Cholesterol Education Program (NCEP) has instituted the following guidelines to assist physicians in diagnosing this syndrome:

• Abdominal obesity. To qualify as a component of metabolic syndrome, a patient’s waist circumference must exceed 35 inches (88 centimeters [cm]) in women and 40 inches (102 cm) in men. Children require a waist circumference at or above the 90^th percentile for age and gender.
  
  
• High blood pressure. The patient’s blood pressure must be greater than 130/85 millimeters of mercury (mm/Hg) for a diagnosis of metabolic syndrome. Again, for children, blood pressures above the 90^th percentile are needed to qualify.
  
  
• Elevated levels of triglycerides. A fatty material that circulates through the blood or is stored as fat tissue. The patient’s triglycerides must be higher than 150 milligrams per deciliter (mg/dL) for adults and 110 mg/dL for children to qualify as a component of metabolic syndrome.
  
  
• Low HDL (high-density lipoprotein) cholesterol. Commonly referred to as “good” cholesterol, HDLs travel freely throughout the bloodstream, helping to reduce “bad” LDL cholesterol and prevent heart disease. For a diagnosis of metabolic syndrome, the patient’s HDL level must be lower than 50 mg/dL in women and 40 mg/dL in men and children.
  
  
• Elevated fasting glucose (blood sugar). The patient’s fasting glucose level must be at least 110 mg/dL (at least 100, according to the American Heart Association) for a diagnosis of metabolic syndrome (men, women and children).

The International Diabetes Federation has recently established slightly different criteria.

Some other conditions frequently accompany metabolic syndrome, but are not necessary to diagnose the syndrome. They include:

• Microalbuminuria. Small amounts of a protein called albumin are found in the urine.
  
  
• Hyperuricemia. A condition characterized by high levels of uric acid (an end product of metabolism) in the blood.
  
  
• Increased levels of blood factors that promote clotting, including fibrinogen and plasminogen activator inhibitor-1 (PAI-1).

Additionally, individuals with metabolic syndrome may have one or more of the following conditions:

• Type 2 diabetes. A metabolic condition in which the body is unable to use insulin properly.
  
  
• Hyperinsulinemia. A condition characterized by abnormally high levels of insulin in the blood.
  
  
• Hyperferremia. Excess iron in the blood, a risk factor for diabetes, heart attack and other conditions.

Diagnosis of metabolic syndrome requires a blood pressure reading, measurement of the waistline using a tape measure and measurement of body weight using a scale. Physicians may also perform a few simple blood tests to measure levels of:

• Glucose
• Insulin (a hormone that regulates glucose)
• Cholesterol and triglycerides
• Uric acid
• Fibrinogen
• PAI-1
• Ferritin (iron)
• Testosterone in men