What are approach considerations in the workup of metabolic syndrome?

Updated: Mar 30, 2020
  • Author: Stanley S Wang, JD, MD, MPH; Chief Editor: Yasmine S Ali, MD, MSCI, FACC, FACP  more...
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Initial laboratory studies in patients suspected of having metabolic syndrome should include standard chemistries to assess for hyperglycemia and renal dysfunction and lipid studies to assess for hypertriglyceridemia or low HDL levels.

If a family history of early coronary or other atherosclerotic disease is present, consider including, in addition to HDL-C and low-density lipoprotein cholesterol (LDL-C), studies of lipoprotein(a), apolipoprotein-B100, high-sensitivity C-reactive protein (CRP), and (if the patient does not already merit the lowest LDL-C target [< 70]), homocysteine and fractionated LDL-C.

In view of the various associations between metabolic syndrome and other conditions discussed elsewhere in this article, additional helpful blood tests may include thyroid and liver studies, hemoglobin-A1C levels, and uric acid. Increased thyroid stimulating hormone (TSH) has been linked to a higher prevalence of metabolic syndrome. [81] Hyperuricemia appears to be much more common in patients with metabolic syndrome than in the general population, and this is attributed to the inflammatory effects of metabolic syndrome. [82] Further studies should be pursued as clinical findings dictate.

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