This calculator is for general information and education. It is not medical advice and does not replace the judgment of a doctor, nurse or pharmacist who knows the full clinical picture.
Five risk factors that travel together
Metabolic syndrome is not a disease in itself but a cluster of five measurements that share a common root, usually excess abdominal fat and insulin resistance. When three or more are present, the risk of heart attack and stroke roughly doubles and the risk of type 2 diabetes rises about fivefold. Around one in three US adults meets the definition, and the share rises steeply with age.
The harmonized criteria
In 2009 the International Diabetes Federation, the American Heart Association, the National Heart, Lung, and Blood Institute and other groups agreed on a single definition. Any three of the following make the diagnosis:
| Criterion | Threshold |
|---|---|
| Waist circumference | population-specific (see below) |
| Triglycerides | 150 mg/dL (1.7 mmol/L) or more, or on treatment |
| HDL cholesterol | below 40 mg/dL (1.0 mmol/L) in men, below 50 mg/dL (1.3 mmol/L) in women, or on treatment |
| Blood pressure | 130 systolic or 85 diastolic or more, or on treatment |
| Fasting glucose | 100 mg/dL (5.6 mmol/L) or more, or on treatment |
For the waist, US guidance uses 102 cm (40 in) for men and 88 cm (35 in) for women. The IDF suggests 94 and 80 cm for people of European descent and 90 and 80 cm for people of Asian descent, who develop insulin resistance at a smaller waist size.
Worked example
A man with a 40-inch waist, triglycerides of 160 mg/dL, HDL of 45 mg/dL, blood pressure of 132/84 mmHg and fasting glucose of 104 mg/dL meets three criteria: triglycerides, blood pressure and glucose. His waist, 101.6 cm, is just under the 102 cm US threshold, and his HDL is above 40. With three of five, he has metabolic syndrome. Using the European waist cut-off of 94 cm, he would meet four.
How to measure your waist
Stand relaxed and breathe out normally. Place the tape horizontally around your abdomen at the top of the hip bones, which is usually at or just above the navel, snug but not compressing the skin. Blood tests should be taken after an 8 to 12 hour fast.
What to do with the result
The good news is that every criterion responds to lifestyle changes. Losing 5 to 10% of body weight, 150 minutes a week of brisk walking or other moderate activity, fewer refined carbohydrates and sugary drinks, less alcohol and quitting smoking can bring several measurements back to normal. Your doctor will also look at your overall cardiovascular risk, with tools such as the AHA PREVENT calculator, to decide whether medication is needed.