Cluster of central obesity, dyslipidaemia, hypertension and dysglycaemia conferring high cardiometabolic risk (≥3 of 5 IDF/NCEP criteria).
Etiology
- • Insulin resistance
- • Visceral adiposity
- • Genetic predisposition
Risk factors
- • Sedentary lifestyle
- • South Asian ethnicity
- • Family history of T2DM/CVD
History taking
- • Onset, duration, progression, severity
- • Aggravating / relieving factors
- • Past history, drugs, allergies, comorbidities
- • Family & social history relevant to presentation
Examination
- • General: vitals, pallor, icterus, oedema, lymphadenopathy
- • Focused system examination
- • Look for red-flag findings
Red flags
- • Haemodynamic instability
- • Rapid deterioration
- • Severe pain or new neurological deficit
Differential diagnosis
- • See differentials section per chief complaint
Recommended investigations
- • Fasting glucose, HbA1c
- • Lipid profile
- • BP, waist circumference
- • LFT (NAFLD screening)
Diagnosis
- • ≥3 of: waist ≥90 cm (M)/80 cm (F) Asians, TG ≥150, HDL <40 M/<50 F, BP ≥130/85, FBG ≥100
Initial treatment / management
- • Lifestyle modification first-line
- • Treat each component to target
Drug therapy
- • Statin if 10-yr CVD risk ≥10%
- • ACEi/ARB for BP
- • Metformin if prediabetes / IGT
Lifestyle advice
- • Aerobic + resistance exercise 150–300 min/week
- • 5–7% weight loss
- • Stop smoking
Follow-up advice
- • Review in 2–4 weeks or earlier if worsening
- • Monitor response to therapy and adverse effects
Patient counselling
- • Explain diagnosis and natural course in lay terms
- • Red-flag symptoms warranting urgent return
- • Adherence to medications and follow-up
Referral criteria
- • Refer if diagnostic uncertainty, complications, or failure of first-line therapy
Clinical pearls
- • Doubles risk of CVD and quintuples risk of T2DM
References
- • Harrison's Principles of Internal Medicine, 21e
- • NICE / WHO guidelines (current edition)
Educational outpatient guide — verify against local guidelines before clinical use.
