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FREE CLINICAL TOOL · IDF 2005 · AHA CKM STAGING · SOUTH ASIAN CALIBRATED

Metabolic Syndrome
Calculator.

IDF 2005 metabolic syndrome criteria with South Asian waist cutoffs, layered with AHA 2023 CKM staging and ESC/EAS 2019 lipid goals.

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Free · No sign-up · Nothing leaves your browser · Educational screening tool, not a diagnosis

IDF 2005 South Asian MetS Criteria
AHA CKM Staging
Non-HDL-C · ApoB · Lp(a) Flags
IAPEN · ASPEN · ESPEN · PREDIMED

Enter Lab & Clinical Values

IDF 2005 + CKM staging · Fasting lab values required · mg/dL units

All calculations run in your browser. No patient data is stored. Fasting lipid panel required for accurate TG & FPG values.
Ethnicity (waist cutoffs)
Sex
Waist Circumference (cm) MANDATORY IDF GATE Measured at navel level, standing, after gentle expiration. This is the required central obesity criterion. Without it, IDF metabolic syndrome cannot be diagnosed however abnormal the other values are.
Measure in
📌 IDF South Asian, men ≥90 cm, women ≥80 cm · Caucasian, men ≥102 cm, women ≥88 cm
Fasting Triglycerides (mg/dL) Fasting sample required. Triglycerides ≥150 mg/dL is the IDF criterion, and a level this high makes ApoB the more reliable marker of atherogenic particle burden. mmol/L × 88.57 = mg/dL
On TG-lowering medication?
HDL Cholesterol (mg/dL) In insulin-resistant states, Non-HDL-C and ApoB track atherogenic risk better than LDL-C. Enter total cholesterol too and Non-HDL-C is calculated for you.
📌 Non-HDL-C = TC − HDL-C. Preferred over LDL-C when triglycerides are raised.
On HDL-raising medication?
📌 CKM targets use LDL-C. Friedewald may underestimate if TG ≥150.
Blood Pressure (mmHg) IDF MetS criterion: ≥130/85 mmHg or antihypertensive treatment. ESC 2024 also defines an "Elevated BP" band at 120–139/70–89 mmHg, which this tool flags separately.
On antihypertensive medication?
Fasting Plasma Glucose (mg/dL) 8-hour fast required. IDF criterion: ≥100 mg/dL (5.6 mmol/L). Prediabetes 100–125 · Diabetes ≥126. mmol/L × 18.02 = mg/dL
📌 Prediabetes 5.7–6.4% · Diabetes ≥6.5%
On antidiabetic medication?
Renal Markers (CKM Staging) CKD advances CKM stage from 1→2. Albuminuria (urine ACR >30 mg/g) or a reduced eGFR each place you at CKM Stage 2 or above, and both together sit higher on the KDIGO risk grid than either alone.
Established CVD / Prior Event Prior MI, stroke, TIA, PCI, CABG, or known coronary/peripheral artery disease classifies patient as CKM Stage 4 if MetS/DM/CKD is also present.
Risk Amplifiers Select all that apply. These do not change the IDF diagnosis. Lp(a) at or above 125 nmol/L is a recognised risk-enhancing factor (2018 AHA/ACC cholesterol guideline), and because the level is genetically set, one measurement in a lifetime is enough for most adults.

IDF 2005 · AHA CKM · ESC/EAS 2019 · PREDIMED · DPP · Portfolio Diet · IAPEN · ESPEN

CRITERIA BURDEN · NOT A RISK SCORE
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IDF MetS
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Diagnosis
CKM STAGE
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AHA 2023

About this tool

Metabolic syndrome is reported as a yes or no. That answer cannot show how far past the thresholds you sit, and it will not change until one criterion flips. This calculator applies the IDF 2005 definition, where central obesity is mandatory and the South Asian waist cutoffs are 90 cm for men and 80 cm for women. It then adds a CKM stage from 0 to 4, which says how far the process has gone, and separately places you in an ESC/EAS risk category, which is what sets your LDL-C, Non-HDL-C and ApoB goals. Keeping those two apart matters: two people at the same stage can carry very different amounts of risk. Non-HDL-C is worked out for you from total cholesterol, because in insulin-resistant states LDL-C understates how many atherogenic particles are actually present. Waist can be entered in centimetres or inches.

WHAT YOU GET

IDF MetS DiagnosisSouth Asian waist cutoffs · binary output
CKM Stage 0–4AHA 2023 unified CVD, kidney and metabolic view
Lipid GoalsLDL-C · Non-HDL-C · ApoB by risk category
MNT ProtocolIndian food-based · IAPEN-compatible referral
Advanced Lipid FlagsApoB · Lp(a) · Non-HDL-C auto-calc
Multi-Guideline TableIDF vs ATP-III vs AHA/NHLBI vs CKM

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Our clinical dietitian will create a personalised, guideline-aligned MNT plan with Indian food equivalents, TG-lowering meal strategy, and IAPEN referral documentation, completely free.

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EVIDENCE BASE

IDF 2005MetS definition with South Asian waist cutoffs
AHA 2023CKM syndrome Presidential Advisory
ESC/EAS 2019LDL-C, non-HDL-C and ApoB goals by risk
PREDIMED 2013MedDiet cut CV events ~30%; MedDiet+nuts raised MetS reversion
DPP 20025–7% weight loss → 58% T2DM risk reduction
IAPEN · ASPEN · ESPENClinical nutrition frameworks for MetS/CKM

TRY ALSO

Heart Disease Risk (FRS)Framingham 10-year CVD risk
Hypertension Risk (ESH/ESC)BP risk + DASH sodium target
Diabetes Risk (FINDRISC+IDRS)Dual-engine Indian risk score

Frequently Asked Questions

What is metabolic syndrome and how is it diagnosed?

Metabolic syndrome is a cluster of cardiometabolic risk factors that together raise the risk of type 2 diabetes and cardiovascular disease. Under the IDF 2005 worldwide consensus definition, central obesity is mandatory, measured as a waist circumference of 90 cm or more in South Asian men and 80 cm or more in South Asian women, plus any two of: triglycerides at or above 150 mg/dL, HDL cholesterol below 40 mg/dL in men or below 50 mg/dL in women, blood pressure at or above 130/85 mmHg, or fasting plasma glucose at or above 100 mg/dL. Being on treatment for any of those counts as meeting that criterion.

Why is the waist cutoff lower for Indians and other South Asians?

South Asian populations accumulate visceral fat and develop insulin resistance at a lower body size than European populations, a pattern often described as the thin-fat phenotype. The IDF therefore sets central obesity at 90 cm for South Asian men and 80 cm for South Asian women, rather than the 102 cm and 88 cm used for Europid populations. Switching this calculator between the South Asian and Caucasian cutoff sets can change the diagnosis for the same person, which is exactly why the ethnicity toggle exists.

What is CKM staging and how does it differ from the metabolic syndrome diagnosis?

Cardiovascular-kidney-metabolic, or CKM, staging was introduced in the American Heart Association 2023 Presidential Advisory to describe how excess adiposity, metabolic risk factors, kidney disease and cardiovascular disease progress together rather than as separate problems. Metabolic syndrome gives a yes or no answer at a single point in time. CKM places you on a track from stage 0, no risk factors, to stage 4, clinical cardiovascular disease alongside metabolic or kidney disease. Your cholesterol goals are set separately, from an overall risk category rather than from the stage itself, because two people at the same stage can carry very different amounts of risk.

Why does this tool report Non-HDL-C and ApoB instead of just LDL-C?

In insulin-resistant states, LDL particles are cholesterol-depleted, so an LDL-C value can look reassuring while the number of atherogenic particles is high. Non-HDL-C, which is simply total cholesterol minus HDL cholesterol and needs no fasting sample, captures every atherogenic particle. ApoB counts those particles directly and is the most accurate of the three when triglycerides are raised. This is also why the Friedewald equation should not be used for LDL-C once triglycerides reach 150 mg/dL: use the Martin-Hopkins or Sampson-NIH equation instead.

What is Lp(a) and should I have it measured?

Lipoprotein(a) is a genetically determined, largely diet-independent lipoprotein that raises cardiovascular risk independently of LDL-C. Because the level is set genetically and stays broadly stable through life, a single measurement is enough for most adults. A level at or around 125 nmol/L, roughly 50 mg/dL, is generally treated as the point where risk is meaningfully increased, and very high levels carry risk comparable to familial hypercholesterolaemia. A raised Lp(a) does not change your diet plan much, but it does change how aggressively LDL-C and ApoB should be lowered, and it is a reason to have first-degree relatives screened.

Can metabolic syndrome be reversed?

The individual components improve substantially with treatment, and people frequently stop meeting the criteria. In the Diabetes Prevention Program, a 5 to 7 percent weight loss with 150 minutes of activity a week cut progression to type 2 diabetes by 58 percent, more than metformin did. PREDIMED found a Mediterranean-pattern diet reduced metabolic syndrome incidence, and the Portfolio Diet lowered LDL-C to a degree comparable with a starting statin dose. Waist circumference, triglycerides, HDL, blood pressure and fasting glucose all respond, though established cardiovascular or kidney disease does not reverse, and medication decisions belong with your doctor.

⚕️ Clinical disclaimer: This is an educational screening tool, not a diagnosis. Metabolic syndrome diagnosis requires clinical confirmation. Lab values (fasting TG, HDL-C, FPG) must be from a certified laboratory after ≥8-hour fast. This tool uses IDF 2005 criteria with South Asian waist cutoffs, AHA 2023 CKM staging, and ESC/EAS 2019 lipid goals by risk category. The score out of 28 is an in-house weighting, not a validated risk instrument. It does not replace clinical judgment, physician diagnosis, or pharmacotherapy decisions. Use Martin-Hopkins or Sampson-NIH equation for LDL-C when TG ≥150 mg/dL.