Diagnostic criteria of metabolic syndrome include(s)- a) high serum homocysteine b) high serum triglyceride c) high serum adiponectin d) low HDL cholesterol e) high LDL cholesterol Diagnostic criterion for Metabolic Syndrome is Elevated serum triglycerides, and low values of HDL. The exact criteria, while differing within different definitions, notable being those given by WHO, IDF(Internation Diabetes Federation) and AHA, all of these surely include Serum TG's and not cholesterol. Low HDL levels are not included in all the guidelines. The primary criterion however remains central obesity or Diabetes Mellitus, depending on what source you're looking at - dyslipidemia, hypertension beings adjuncts. So in my opinion, based on the above knowledge, best answer should be Elevated serum TG's. Also, i myself asked this question to one of my professors and this is the answer i got. The exact articles can be found on the internet. I dont think posting links is allowed here.