Which lipid abnormality is most characteristic of metabolic syndrome?

• A. Elevated HDL
• B. Elevated LDL with decreased TG
• C. Elevated triglycerides
• D. Low total cholesterol

Answer: (C)

Metabolic syndrome is driven by insulin resistance and shows a characteristic dyslipidemia with high triglycerides and low HDL cholesterol. The lipid pattern most typical is elevated triglycerides, arising from increased hepatic production of VLDL and reduced clearance due to insulin resistance. This hypertriglyceridemia often coincides with HDL being low because triglyceride-rich lipoproteins exchange TG for cholesterol esters, altering HDL particles and promoting their clearance. LDL particles may be normal or not as predictive of the syndrome, and total cholesterol alone isn’t the defining feature. Therefore, elevated triglycerides best captures the lipid abnormality you’d expect in metabolic syndrome.