What criteria should I use to diagnose metabolic syndrome in my patients?

To diagnose metabolic syndrome in your patients, use the following criteria which integrate UK clinical guidelines and international literature: presence of central obesity defined by waist circumference (≥94 cm in men, ≥80 cm in women for European populations) plus any two of the following factors: raised triglycerides (≥1.7 mmol/L), reduced HDL cholesterol (<1.03 mmol/L in men, <1.29 mmol/L in women), raised blood pressure (systolic ≥130 mmHg or diastolic ≥85 mmHg or treatment for hypertension), and raised fasting plasma glucose (≥5.6 mmol/L) or previously diagnosed type 2 diabetes NICE. This approach aligns with the harmonised definition widely accepted internationally, including the International Diabetes Federation and the American Heart Association, and is supported by evidence emphasizing the importance of central obesity as a key component Kassi et al. 2011.

UK guidelines (PH35, NG246) emphasise lifestyle factors and the clustering of these metabolic risk factors to identify patients at high risk of cardiovascular disease and type 2 diabetes, recommending that diagnosis should prompt interventions targeting weight, diet, and physical activity NICE. Recent literature also highlights that while these criteria are standard, some populations may require adjusted waist circumference thresholds, and that lifestyle modification can reduce the number of diagnostic criteria present, thus improving clinical outcomes Piovesan et al. 2021Yamagishi & Iso 2017. Therefore, while the core diagnostic criteria remain consistent, consider patient ethnicity and individual risk factors when applying these thresholds in practice.