How many criteria are required for a diagnosis of metabolic syndrome?

• A. 2 of 5
• B. 4 of 5
• C. 5 of 5
• D. 3 of 5

Answer: (D)

Metabolic syndrome is diagnosed when several risk factors cluster together, not from a single value. The standard rule is that at least three of five specific abnormalities must be present: increased waist circumference (central obesity), high triglycerides, low HDL cholesterol, elevated blood pressure, and elevated fasting glucose. Reaching three of these five indicates a metabolic disturbance that raises risk for cardiovascular disease and diabetes, which is why the threshold is three. Some guidelines vary in details (for example, requiring central obesity plus two other factors), but the commonly used approach is three of five to diagnose the syndrome.