Step 1: NCEP-ATP III defines metabolic syndrome by 5 criteria, and a diagnosis needs any 3 of them:
- Central obesity (raised waist circumference)
- Elevated triglycerides (>150 mg/dL)
- Low HDL cholesterol (men <40, women <50 mg/dL)
- Raised blood pressure (>130/85 mm Hg)
- Raised fasting glucose (>100 mg/dL)
Step 2: The lipid criteria are high triglycerides and low HDL. LDL is NOT part of the definition.
Step 3: So hypertriglyceridemia, central obesity and hypertension are all included, while high LDL is the exception. The correct answer is high LDL.
Ref: DM Vasudevan, Textbook of Biochemistry, 6th edn, pg 286.