Process - Physician - Fraser Health Authority

Diagnostic Criteria and Risk Level DefinitionsCriteria for clinical diagnosis of Metabolic SyndromeClinical diagnosis of metabolic syndrome = Any three (3) or more of fiverisk factors are present:Risk factor Defining levelRelated medicalconditionElevated waist Male: ≥ 102 cm (40 inches) Abdominal obesitycircumference a,b Female: ≥ 88 cm (35 inches)Elevated bloodpressureIf no co-morbid conditions: >140/90If self measured: > 135/85If client has diabetes, renaldisease or other target organdamage c : > 130/80Hypertensionor drug treatment forhypertensionElevatedtriglyceridesReduced highdensitylipoproteincholesterol (HDL-C)Elevated fastingglucose e(antihypertensive)> 1.7 mmol/LHigh cholesterol /or drug treatment for elevated Dyslipidemiatriglycerides dMale: < 1.03 mmol/L High cholesterol /Female: < 1.29 mmol/L Dyslipidemiaor drug treatment for reducedHDL-C d≥ 5.6 mmol/L or drug treatmentfor elevated glucoseDiabetesNotes:a If waist circumference is difficult to obtain, abdominal obesity may be ‘eye-balled’or if BMI is ≥ 30 kg/m 2 , it can be initially assumed.b The Health Canada defining levels for waist circumference are recommended foruse with all Canadian adults (except for pregnant and lactating women) and areused in these guidelines. Ethnic-specific data is available in the guidelines.c Target organ damage includes: cerebrovascular disease, coronary heart disease(CHD), left ventricular hypertrophy (LVH), chronic kidney disease (CKD),peripheral vascular disease and hypertensive retinopathy.d The most commonly used drugs for elevated triglycerides and reduced HDL-Care fibrates and nicotinic acid. A patient taking one of these drugs can bepresumed to have high triglycerides and low HDL-C.e Most with type 2 diabetes mellitus will have metabolic syndrome by this criteria.Risk levels definitionsRisk levelHigh riskModerateriskLow riskDefinitionAny of the following conditions are present:• On psychotropic mes AND presence of any risk factors or ontreatment for any risk factors; OR• New start on psychotropic medications with high or moderaterisk of weight gain (see Tables 7 and 8)Any of the following conditions are present:• New start on all other psychotropic meds (those with low risk ofweight gain – see Tables 7 and 8); OR• On psychotropic medications but no changes in past 3 months 1 ;OR• Greater than or equal to 5% increase in weight seen 2• No metabolic risk factors present; AND not on psychotropicmedicationsRevised April 11, 2011 Page 2 of 2 Mental Health and Substance Use