Laboratory Assessment of the Metabolic Syndrome
The symptom complex that defines the MeS is a state of insulin resistance delineated by the presence of at least three of the following five traits: abdominal obesity, impaired fasting glucose, hypertension, hypertriglyceridemia and low HDL-cholesterol (Table 1).[91,92,93,94] The cornerstone of this cluster of metabolic abnormalities is hyperinsulinemia, which can contribute to local renal pathology including renal mesangial expansion (a step in the progression to glomerulosclerosis), hyperuricemia and renal tubular salt retention.[88,90,92,93] Clinical measures of the MeS and insulin resistance include the homeostatic model assessment of insulin resistance (HOMA-IR) calculated from the following equation:
Other markers of inflammation associated with the MeS include uric acid, high sensitivity C-reactive protein and glycosylated hemoglobin. In addition, it is advisable to monitor the fasting lipids since dyslipidemia appears to aggravate the proteinuria and is a major component of the MeS.[92,93]
Pediatr Health. 2009;3(2):141-153. © 2009 Future Medicine Ltd.