Various definitions and criteria used to diagnose metabolic syndrome. Its a common observation that central obesity, high blood pressure and impaired fasting sugars are an important triad. So I propose fasting blood sugar as a single blood test to identify metabolic syndrome in poor resource setting.
Obviously, it is cost effective but not reliable. Imagine, your patient has normal fasting glucose + central obesity. So what?
I only mean the sensitivity of picking up metabolic syndrome with this triad using only one blood test.
Guess, that in case of positive triad you can do what you can for patient without trying to diagnose metabolic syndrome (MS). The notion itself (of MS) is under debate. Good luck!
Yes it is the cost effective way as we can presume so much from Waist to Hip ratio. we observed in our multicenter study that all subjects whose had higher lipid profile, dyslipidemia, had also W/H ratio more than 1. It gives us an idea of obesity and since MS is a triad, so if we measure W/H ratio along with blood sugar we arrive in tentative diagnosis in a cost effective way. In my sudy working on normolipidemia AMI patients, we also observed the results in a very similar line. Even though the lipid profile were normal but the ratio of LDL-C/HDL-C, TC/HDL-C and TG/HDL-C were more than 6 and all of them had >1 W/H ratio.
This is definitely a very interesting & relevant question . An obese person can have normal BP , normal fasting blood sugar & normal lipids . Can we consider them as healthy obese ? In Indians , persons with normal BMI can have abdominal obesity , raised blood sugar & increased BP . Therefore , we can have obese & non obese persons with central obesity , hypertension & impaired fasting glucose . Abdominal obesity should be an indication for screening for BP & blood sugar . Those who have metabolic syndrome should be screened for lipid disorders .
I think that lipid profile is necessary to diagnose metabolic syndrome too.
Di Fronzo says that metabolic syndrome is the expression of Insulin resistance, If you see Hypertrigliceridemia, the dyslipemia also masks Small dense LDL , which are more oxidable , and low plasma levels of HDL-Cholesterol. MS is ver important, do no try measure low cost factors to diagnose it. Sooner o later yo will know which factors are mre usefu fo your population.
On clinical basis, you can predict the presence of metabolic syndrome using waist to heigth ratio (WTH). As Arun Kumar said in his answer, an elevated WTH atio is strongly predictive of metabolic abnormalities. In our experience, a WTH > 0.62 is predictive of metabolic syndrome in children and adolescents.
I would like to remember that in chidren glycemia usually is normal, it's better to use insulin or insulin resistance .