Metabolic Syndrome Criteria

Helps diagnose metabolic syndrome based on blood pressure, HDL cholesterol, triglycerides and glucose.

Read more about the criteria involved in diagnosis and about other systems in the text below the calculator.

The metabolic syndrome criteria uses the patient’s degree of abdominal obesity, triglyceride and HDL cholesterol levels, along with blood pressure and fasting glucose to diagnose metabolic syndrome.

This is a tool proposed by the American Heart Association and the National Heart Lung and Blood Institute.

If three or more of the five criteria are present, then metabolic syndrome diagnosis is likely positive.

Risk factors for metabolic syndrome include:

■ Hypertension;

■ Elevated blood sugar;

■ High triglycerides;

■ Low HDL cholesterol;

■ Obesity.


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The criteria explained

The American Heart Association and the National Heart Lung and Blood Institute have devised a model that helps with diagnosis of metabolic syndrome.

The table below introduces the five criteria used in the calculator:

Criteria When it increases risk of metabolic syndrome
Abdominal obesity Waist dimension >35 in or 88 cm for women
Waist dimension >40 in or 101 cm for men
Triglycerides ≥150 mg/dL or patient on triglyceride lowering prescription
HDL cholesterol <50 mg/dL for women
<40 mg/dL for men
Blood pressure ≥130 mmHg for systolic BP and ≥85 mmHg for diastolic BP
Fasting glucose ≥100 mg/dL or on glucose lowering prescription

Positive diagnosis is highly likely if at least three of the five criteria are present.

The above criteria are actual risk factors, traits or conditions that increase the chances for the patient to develop cardiovascular disease, suffer a stroke or be diagnosed with diabetes.

Patients who are diagnosed with metabolic syndrome often suffer from:

■ Hypertension;

■ Elevated blood sugar;

■ High triglycerides;

■ Low HDL cholesterol;

■ Obesity.


About metabolic syndrome

MS consists of a cluster of interrelated factors associated with increased risk of cardiovascular disease, type 2 diabetes and stroke. It is also known as insulin resistance syndrome or syndrome X.

Diagnosis is put after physical exam, and blood tests (especially for cholesterol and blood glucose levels).

Research has started to investigate the effect of stress on hormonal balance of the HPA-axis, which, when disrupted lets high cortisol levels in circulation, thus increasing glucose and insulin levels.

Treatment is focused on resolving the underlying causes for high blood pressure, high sugar or low HDL and also on initiating healthy lifestyle changes.

Metabolic syndrome is often associated with Coronary Heart Disease (CHD), cerebrovascular disease and hypertension.


Other diagnosis criteria

The following table contains 4 different diagnosis models for metabolic syndrome, with their criteria:

Diagnosis model Positive diagnosis Criteria
The International Diabetes Federation (IDF) Worldwide Definition of the Metabolic Syndrome (2005) Required criteria + 2 other. Required criteria: abdominal obesity (population specific).
Other Criteria:
- Triglycerides ≥150 mg/dL or on TG lowering Rx;
- HDL-C <40 mg/dL in men or <50 mg/dL in women or on HDL-C Rx;
- Blood pressure ≥130/ ≥85 mmHg or on BP med;
- Glucose: ≥100 mg/dL or Rx of DM.
Metabolic Syndrome Criteria (AACE 2003) Required criteria + 1 other. Required criteria: Insulin Resistance: IGT or IFG.
Other criteria:
- BMI ≥25;
- Triglycerides ≥150 mg/dL and HDL-C <40 mg/dL in men or <50 in women;
- Blood pressure ≥130/ ≥85 mmHg;
- Glucose: IGT, IFG but NOT DM;
- Other features of insulin resistance.
Metabolic Syndrome Criteria (WHO 1998) Required criteria + 2 other. Required criteria: Insulin Resistance (IGT, IFG, Type 2 DM or reduced insulin sensitivity).
Other criteria:
- Abdominal obesity (Waist/Hip ratio >0.9 in men ; >0.85 in women) or BMI >30;
- Triglycerides ≥150 mg/dL or HDL-C <35 mg/dL in men or <39 in women;
- Blood pressure ≥140/ ≥90 mmHg;
- Glucose: IGT, IFG or Type 2 DM;
- Microalbuminuria.
Metabolic Syndrome Criteria (EGIR) Required criteria + 2 other. Required criteria: Plasma insulin >75'th percentile.
Other criteria:
- Abdominal obesity (Waist circumference ≥94 cm in men; ≥80 cm in women);
- Triglycerides ≥150 mg/dL or HDL-C <39 mg/dL;
- Blood pressure ≥140/ ≥90 mmHg or on BP med;
- Glucose: IGT, IFG but not DM.


1. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F; American Heart Association; National Heart, Lung, and Blood Institute. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005; 112(17):2735-52.

2. Huang PL. A comprehensive definition for metabolic syndrome. Dis Model Mech. 2009; 2(5-6): 231–237.

3. Strazzullo P, Barbato A, Siani A, Cappuccio FP, Versiero M, Schiattarella P, Russo O, Avallone S, della Valle E, Farinaro E. Diagnostic criteria for metabolic syndrome: a comparative analysis in an unselected sample of adult male population. Metabolism. 2008; 57(3):355-61.

Specialty: Emergency

Objective: Evaluation

Type: Criteria

No. Of Criteria: 5

Article By: Denise Nedea

Published On: June 1, 2017

Last Checked: June 1, 2017

Next Review: June 1, 2023