The diagnosis of metabolic syndrome is mostly based on physical examination and lab tests. The diagnostic criteria of different international societies also involves consideration of lab tests like lipid profile and fasting blood glucose.

• Blood glucose (fasting, post-prandial) and HbA1C to assess for diabetes
• Renal function tests like serum uric acid and urinary microalbumin to look for renal dysfunction. Hyperuricemia has been frequently shown to be associated with metabolic syndrome.
• Lipid profile – hypertriglyceridemia or low HDL levels to assess dyslipidemia.^{[1] [1]}
• Thyroid function tests – as increased thyroid stimulating hormone (TSH) has been linked to a higher prevalence of metabolic syndrome
• Liver function tests
• Urine analysis may show high levels of uric acid and microalbuminuria (correlates with an insulin resistant state)

Metabolic syndrome is a proinflammatory and prothrombotic state. Additional biomarkers that are worth measuring while evaluating metabolic syndrome include:

• ApoB
• High sensitivity CRP
• Fibrinogen
• Homocysteine

Studies have shown that elevated levels of these proinflammatory and prothrombotic biomarkers are associated with an increased risk for coronary artery disease (CAD) and type II diabetes. Hence measurement of these markers should be considered in the setting of CAD risk assessment.

If PCOS is suspected the following lab tests should be included in the management of metabolic syndrome:

• Serum testosterone
• Serum leutinizing hormone
• Serum FSH