Diagnostic Criteria and Clinical Management of Metabolic Syndrome in Diabetes

Diagnostic Criteria (American Heart Association/NHLBI)

Diabetes‑Specific Considerations

Clinical Implications

Management Recommendations

Definition Harmonization

Diagnostic Criteria for Metabolic Syndrome

Definition and Diagnostic Components

• The American Heart Association recommends that metabolic syndrome is diagnosed when a patient has at least 3 of the following 5 criteria: elevated waist circumference, elevated triglycerides, low HDL cholesterol, elevated blood pressure, and elevated fasting glucose 4, 5, 6, 7
• The International Diabetes Federation suggests that central obesity is not mandatory for diagnosis, and any 3 of the 5 components qualify for diagnosis 7, 8, 9

Diagnostic Criteria

• Elevated waist circumference is defined as ≥102 cm in men and ≥88 cm in women, according to the American Heart Association 4, 10, 11
• Elevated triglycerides are defined as ≥1.7 mmol/L (150 mg/dL), as recommended by the American Heart Association 4, 10, 11
• Low HDL cholesterol is defined as <1.03 mmol/L (<40 mg/dL) in men and <1.29 mmol/L (<50 mg/dL) in women, according to the American Heart Association 4, 10, 11
• Elevated blood pressure is defined as systolic BP ≥130 mmHg and/or diastolic BP ≥85 mmHg, as recommended by the American Heart Association 4, 10, 11
• Elevated fasting glucose is defined as ≥5.6 mmol/L (100 mg/dL), according to the American Heart Association 4, 10, 11

Clinical Significance

• Patients with metabolic syndrome have a 2-fold increased risk of cardiovascular disease over 5-10 years, as reported by the American Heart Association 4, 6
• The syndrome confers a 5-fold increased risk for type 2 diabetes mellitus, according to the American Heart Association 4, 6