Metabolic syndrome, also known as syndrome X or insulin resistance syndrome, refers to the co-occurrence of metabolic risk factors for both type 2 diabetes mellitus and coronary vascular disease, including abdominal obesity, hyperglycemia, dyslipidemia, and hypertension. Prevalence continues to increase worldwide, especially in African-American and Mexican-American populations. Risk factors for development include an elevated body mass index (BMI), especially abdominal obesity, increasing age, African-American or Mexican-American descent, postmenopausal status, smoking, a high-carbohydrate diet, physical inactivity, clozapine use, and low household income.
The US National Cholesterol Education Program Adult Treatment Panel (ATP) III definition of metabolic syndrome requires patients to have any 3 of the following 5 traits:
Abdominal obesity – Waist circumference ≥ 102 cm (40 inches) for men and ≥ 88 cm (35 inches) for women.
Serum triglycerides ≥ 150 mg/dL or drug treatment for elevated triglycerides.
High-density lipoprotein (HDL) < 40 mg/dL in men and < 50 mg/dL in women or drug treatment for low HDL cholesterol.
Blood pressure ≥ 130/85 mm Hg or drug treatment for elevated blood pressure.
Fasting plasma glucose ≥ 100 mg/dL (5.6 mmol/L) or drug treatment for elevated blood glucose.
Codes
ICD10CM: E88.81 – Metabolic syndrome
SNOMEDCT: 237602007 – Metabolic syndrome x
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
Secondary causes should be investigated for each trait based on individual presentation.
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
