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A doctor may suspect that a patient has metabolic syndrome if he or she has central/abdominal obesity and a sedentary lifestyle, but both laboratory and non-laboratory tests are important in establishing the diagnosis. Recommended tests include:

Laboratory tests

  • Glucose Usually a fasting glucose test is performed but, in some cases, a doctor also may order GTT (glucose tolerance test – several glucose tests that are taken before and at timed intervals after a glucose challenge). The goal of glucose testing is to determine whether a patient has diabetes or an impaired response to glucose.
  • Lipid profile Measures HDL, LDL and triglycerides. If the triglycerides are significantly elevated, a DLDL (direct measurement of the LDL) may need to be done.
  • Haemoglobin A1c (HbA1c). This is a measure of glucose control and can be used for the diagnosis of diabetes.

There are other laboratory tests that are not recommended for diagnosing metabolic syndrome but that may ordered by some doctors to provide additional information. They may include:

  • C-peptide. This is a reliable indicator of endogenous (a person's own) insulin production.
  • Insulin: The fasting insulin test is considered too variable to be clinically useful in diagnosing metabolic syndrome but, if measured, will usually be elevated in those affected.
  • Albumin/creatinine ratio: An early indicator of kidney disease, this test is used to help monitor diabetics and is recommended under the WHO criteria.
  • hs-CRP (highly sensitive C-reactive protein): A measure of low levels of inflammation that may be tested as part of an evaluation of cardiac risk.
  • sdLDL: This is a measurement of the number of smalll dense low-density lipoprotein molecules a person has. LDL varis in size, and the smaller denser molecules, which tend to form when elevated triglyerides and VLDL are present in the blood, are thought to be more aggressive in causing atherosclerosis. This test is performed as "LDL subclasses"assessment by electrophoresis. A Medicare rebate is available if Medicare criteria are met. These are cholestrol ≥6.5 mmol/L and triglyerides >4.0mmol/L or in the diagnosis of types III and IV hyperlipidemia.

Tests for which the clinical utility in diagnosing metabolic syndrome have not yet been established include plasminogen activator inhibitor-1 (PAI-1) and proinsulin.

Non-laboratory tests

  • Blood pressure - to check for hypertension
  • Weight and waist circumference - to document abdominal obesity
  • BMI (body mass index) - an alternate measure of obesity that is used by many doctors. It is calculated by taking: (weight in kilograms) / (height in metres squared).
    For example: (80 kg) / (1.7m X 1.7m) = a BMI of 27.7Kg/m². An adult with a BMI greater than 30 Kg/m² is considered obese. (This calculation does not, however, describe where the excess weight is on the body.)

Last Review Date: October 25, 2018