Which finding would support a diagnosis of metabolic syndrome in this patient?

• A. Fasting blood sugar level of 90 mg/dL
• B. HDL level of 35 mg/dL
• C. LDL level of 150 mg/dL
• D. Triglyceride level of 120 mg/dL

Answer: (B)

Metabolic syndrome is a clustering of metabolic risk factors that raise the risk for cardiovascular disease and type 2 diabetes. A diagnosis is made when at least three features are present: elevated fasting glucose (≥100 mg/dL or on treatment), high triglycerides (≥150 mg/dL), low HDL cholesterol (less than 40 mg/dL in men or less than 50 mg/dL in women), elevated blood pressure (≥130/85 mmHg), and increased abdominal obesity. Here, the HDL level of 35 mg/dL is below the normal threshold and would count toward the syndrome. The other findings—normal fasting glucose, triglycerides not elevated, and LDL not used in the metabolic syndrome criteria—don’t by themselves support the diagnosis. So the low HDL is the finding that supports metabolic syndrome.