Get Ahead of Metabolic Syndrome at Your Annual Physical

Content medically reviewed by Emily Bergstedt, MD

An annual physical exam with a primary care provider (PCP) helps you stay in the know about your health. The tests and labs that are part of a typical physical can reveal whether you have risk factors for chronic health problems, like diabetes. When several specific risk factors occur together, it’s known as metabolic syndrome. Learn more about this group of risk factors and how lab results from your annual physical can help you change the trajectory of your health.

Metabolic Syndrome, Defined

So, what is metabolic syndrome? It’s not a condition in its own right. Rather, it’s a collection of risk factors that, together, increase your risk of developing diabetes, heart disease, liver disease, and other serious health conditions. Metabolic syndrome is also widespread: Around one-third of Americans have it, according to the National Heart, Lung, and Blood Institute.

You may be diagnosed with metabolic syndrome if you have at least three of the following five risk factors –

• A large waistline (abdominal obesity)
• High blood pressure
• High blood sugar (glucose) levels
• High levels of triglycerides, a type of fat in the blood
• Low levels of “good” high-density lipoprotein (HDL) cholesterol in the blood

“Metabolic syndrome has few symptoms or early warning signs because the risk factors that comprise it usually develop silently,” said Dr. Emily Bergstedt, a family medicine physician at Essentia Health. “The tests you’ll have during an annual physical, such as a lipid panel and hemoglobin A1C, can uncover metabolic syndrome in the absence of noticeable signs.”

Who’s at Risk for Metabolic Syndrome?

Many factors can contribute to metabolic syndrome. You are more likely to have metabolic syndrome if you –

• Have an unhealthy diet
• Are an older adult (risk increases with age)
• Don’t get enough physical activity
• Have a family history of metabolic syndrome
• Have a high body weight
• Have diabetes or a family history of it
• Have insulin resistance (your body struggles to use the hormone insulin to help turn blood sugar into energy)
• Have polyendocrrine metabolic endocrine syndrome, formerly known as polycystic ovary syndrome (a hormone-related condition that causes cysts to form on a woman’s ovaries)
• Have sleep apnea or other sleep problems
• Take certain medications

5 in Focus: The Risk Factors Comprising Metabolic Syndrome

Here’s how each of metabolic syndrome’s five risk factors can affect your health, and what you can learn about them from tests at your annual physical.

1. High Blood Pressure

Why it matters: High blood pressure can damage your arteries and lead to plaque buildup. This increases your risk for future heart attacks, strokes, and kidney disease.

Put it to the test: A blood pressure check is a routine part of an annual physical. High blood pressure is 130/80 millimeters of mercury (mm/Hg) or higher.

2. High Blood Sugar

Why it matters: High blood sugar levels can harm your blood vessels and may lead to prediabetes, a potential precursor to Type 2 diabetes.

Put it to the test: During your physical, your PCP will typically measure your blood sugar levels with a fasting blood sugar test or an HbA1c test. A fasting glucose test requires you to avoid eating or drinking for several hours in advance so your blood sugar won’t spike before the test. High blood sugar is 100 milligrams per deciliter (mg/dL) or higher. A hemoglobin A1c does not require you to fast.

3. High Triglycerides

Why it matters: High triglyceride levels can drive up LDL, increasing your heart disease risk.

Put it to the test: The fasting lipid profile will reveal your triglyceride levels. A high result is 150 mg/dL or higher.

4. Large Waistline

Why it matters: Having an apple-shaped body (higher weight around your middle) means there’s excess fat around your stomach and organs, which raises your heart disease risk.

Put it to the test: Your PCP may measure your waist circumference. You have a large waistline if your waist circumference exceeds 40 inches (for men) or 35 inches (for women). However, waist circumference goals differ by ethnicity. For example, for people of South Asian descent, a large waistline is defined as greater than 35.5 inches (for men) or 31.5 inches (for women).

5. Low HDL Cholesterol

Why it matters: HDL helps remove “bad” low-density lipoprotein (LDL) cholesterol from your arteries, keeping them healthy. Without enough HDL, your arteries can get clogged with plaque.

Put it to the test: Your PCP will take a blood sample for a lipid profile. This test measures HDL, LDL, triglycerides, and total cholesterol. Your HDL is low if it’s less than 40 mg/dL (for men) or 50 mg/dL (for women).

How Your PCP Can Help

Your PCP sees the full picture of your health (and knows the full story). That allows them to diagnose metabolic syndrome and help you address each risk factor.

“When we review your lab results, we don’t look at any single number on its own. We consider the full picture—your blood work, personal health history, family history, and your age—to understand what these results mean for you specifically,” Dr. Bergstedt said. “The good news is that catching these warning signs early gives us the opportunity to act. Together, we can build a plan using lifestyle changes and, when needed, medications to lower your risk, protect your health, and help you live a longer, healthier life.”

Here’s what you can do –

• Be a good manager. Follow your treatment plans and take medications as prescribed to manage risk factors like high blood pressure and unhealthy cholesterol levels.
• Eat a heart-healthy diet. Incorporate good-for-you foods, such as fruits, vegetables, whole grains, healthy proteins, and healthy fats, like olive oil, avocado, and tree nuts. Limit or avoid processed foods, which are high in sodium and added sugars.
• Exercise routinely. Regular physical activity is key to reversing or preventing metabolic syndrome. Aim for 150 minutes of aerobic exercise per week in addition to strength training.
• Follow up. See your PCP regularly so they can monitor your health and risk factors.

The Bottom Line

Metabolic syndrome is a wake-up call about your health, and your PCP can help you respond.

Here’s what to know –

• Metabolic syndrome is when you have at least three of these five health risk factors: high blood sugar, low HDL, high triglycerides, a large waistline, and high blood pressure. These risk factors increase the chances of developing serious health conditions, like diabetes or heart disease.
• During your annual physical, your PCP can use tests such as a fasting blood sugar test or A1c, lipid profile, and others to assess your risk factors and determine whether you have metabolic syndrome.
• Making healthy lifestyle changes, such as exercising and following a balanced diet, can help you reverse metabolic syndrome.