Hypertriglyceridemia is a practical biomarker of metabolic syndrome in individuals with abdominal obesity.

Individuals with the metabolic syndrome have a significantly higher risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease. Body mass index (BMI) and waist circumference are inaccurate methods for assessing abdominal obesity; in addition, some obese individuals are metabolically healthy while some normal weight individuals have metabolic syndrome. The methods used to visualize intra-abdominal fat, such as computed tomography (CT) scan and magnetic resonance imaging (MRI), are not available to primary care practitioners as screening methods for the primary care patient. The present study examined commonly used biomarkers to assess which of them would be most predictive of metabolic syndrome to assess the feasibility of using indicators other than BMI in the assessment of obesity-associated disease risk in the primary care setting. We examined 169 (118 females, 51 males) obese individuals with increased waist circumference (>102 cm for men and >85 cm for women), who were patients at the UCLA Risk Factor Obesity Clinic. Of these, 59 had three or more criteria associated with metabolic syndrome. In a multivariate linear regression model including body weight, BMI, waist circumference, waist-to-hip ratio, systolic blood pressure, diastolic blood pressure, glucose, high-density lipoprotein, and triglycerides (TG), only log TG and glucose values were significantly associated with the presence of metabolic syndrome (p<0.001). Both TG and fasting glucose levels were significantly and positively correlated with fasting insulin (p<0.001), homeostasis model assessment (HOMA) (p<0.001). TG were correlated negatively with adiponectin (p<0.01) and positively with high-sensitivity C-reactive protein. We conclude that the presence of elevated TG is independently associated with metabolic syndrome and is a likely predictor for insulin resistance in individuals with increased waist circumference. This finding has significant implications for screening obese and normal weight individuals in the general population for clinically significant metabolic syndrome and prediabetes, which has a major public health impact given the common occurrence of metabolic syndrome and the need for early intervention to prevent T2DM.