A Diagnosis for the Metabolic Syndrome Involves:
A person is diagnosed with the Metabolic Syndrome when they have three or more of the risk factors that define the syndrome. These risk factors are described in the article What is the Metabolic Syndrome?.
They include:
- Obestiy, especially around the middle
- High triglceride levels (blood fats)
- Low HDL Cholesterol (good) levels
- High blood pressure
- High fasting blood sugar levels
- Type 2 diabetes or impaired glucose tolerance
- High Albumin levels in the urine
- Inflammatory State - Elevated C-reactive protein in the blood
Your doctor will determine if you have any of these risk factors by a thorough assessment. Three things will happen during your visit to the doctor: 1) Medical History, 2) Physical Assessment and 3) Laboratory Tests.
A Complete Medical History.
Plan for your visit to your doctor by writing down some of the following before you go. Also write down any questions you have for your doctor. We tend to forget so many things when we get involved in our visit.
- Your diet including alcohol consumption - What do you eat on a normal day? Have you been on any special diets?
- Weight patterns ? Do you have any new unexplained loss or gains?
- Smoking--How long, how much? Did you quit smoking? When did you quit?
- Prescribed drugs, oral contraceptives, vitamins, herbal remedies and street drug use are all important to report,
- Amount of physical activity - daily physical activity, job and leisure, intensity and time you are active and how much time you are sedentary?
- Stresses in your life - Do you work shifts?
- Do you have frequent thirst, urge to urinate, hunger?
- Do you have problems with your eyesight or hearing?
- Do you have numbness or tingling in your feet and hands?
- Do you have frequent bladder or vaginal infections?
- A history of any illness and surgeries,
- A family history including living and deceased parents and siblings, how they died and any health problems they have. A family history of heart disease, diabetes and stroke are especially important to report.
- Your physician will also assess how ready and able you are to make serious changes in your life.
Physical Examination
An exam that screens for the Metabolic Syndrome will include:
- A measurement of your height and weight: Your Body Mass Index (BMI) will be calculated. Your [weight (lb) / [height (in)]2 x 703. This page from the Center for Disease Control will calculate your BMI for you.
Underweight = BMI less than 18.5
Normal weight = BMI of 18.5-24.9
Overweight = BMI of 25-29.9
Obesity = BMI of 30 or greater
- A measurement of your waist: Some, but not all physicians will take this measurement. The circumference of your waist will be measured at the narrowest point between your belly button and your rib cage. If you are a man and your waist is greater than 40 inches or if you are a woman and your waist is greater than 35 inches you have a risk factor for the Metabolic Syndrome.
- A measurement of your blood pressure: If you have a blood pressure that is 130/85 millimeters of mercury (mm Hg) or more, you have a risk factor for the Metabolic Syndrome.
- Your heart rate and rhythm: Your doctor may perform a simple test called an electrocardiogram (EKG or ECG). This is a simple, quick and non-invasive test that will measure your heart rate and rhythm to see if you have any signs of damage or injury to your heart. Many times doctors, who have the ability to do this in their office, perform an EKG during the first visit. This is helpful if you are ever admitted to the hospital with chest pain because the EKGs can be compared to see if there is any new damage.
Laboratory Tests
- Blood Glucose - A fasting glucose (FBG) test is taken to determine if you have an impaired or malfunctioning response to glucose. If you have a FBG of 110 mg/dL (6.1 mmol/L) or more you have a risk factor.
- Oral Glucose Tolerance Test - This is a test to see how your body handles glucose or sugar over time. You are required to fast from eating, drinking and smoking 8 hours prior to the test. The lab will take a fasting blood glucose sample when you arrive. This helps as a basis of comparison to your blood glucose levels during the test. You are given 75 g (3 oz.) of glucose to drink quickly. If you are pregnant, you will be given 50 (2 oz.). Your blood sugar is then tested again after 2 hours. If you are pregnant your blood sugar will be tested after 1 hour and then again after 2 hours. If your results are normal, your blood sugar results will be below 140 mg/dL (7.6 mmol/L) 2 hours after the drinking the glucose. In the Metabolic Syndrome, or what is considered pre-diabetes, the 2-hour blood glucose level is 140 to 199 mg/dL. (7.6 to 11.1 mmol/L). People with blood glucose levels above 199 mg/dL (11.1 mmol/L) are considered to have diabetes.
- High-Density Lipoproteins (HDL) good cholesterol - If your levels are less than 35 mg/dL (0.9 mmol/L) for men or less than 39 mg/dL (1.0 mmol per L) for women, you have a risk factor.
- Low-Density Lipoproteins (LDL) bad cholesterol - A total cholesterol count that includes the LDL level may be taken. High levels of LDLs especially with small particle size are recognized as contributing to heart disease and is a risk factor for the Metabolic Syndrome. This test is not usually taken because if the patient is found to have low HDL cholesterol and high triglyceride levels, they will also have high LDL levels with small particle size.
- Triglycerides - If your levels are 150 mg/dL (1.7 mmol/L) or greater you have a risk factor.