**Core Concept**
The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) defines metabolic syndrome as a cluster of conditions that occur together, increasing the risk of cardiovascular disease. These conditions include central obesity, high blood pressure, elevated fasting glucose, high triglycerides, and low HDL cholesterol.

**Why the Correct Answer is Right**
Metabolic syndrome is characterized by a combination of insulin resistance, inflammation, and endothelial dysfunction, which contribute to the development of atherosclerosis. The NCEP ATP III criteria specifically include:
- Central obesity (waist circumference >102 cm in men and >88 cm in women)
- Triglycerides ≥150 mg/dL
- HDL cholesterol <40 mg/dL in men and <50 mg/dL in women - Blood pressure ≥130/85 mmHg - Fasting glucose ≥100 mg/dL **Why Each Wrong Option is Incorrect** **Option A:** Central obesity is actually a key component of metabolic syndrome, so this option is not the correct answer. **Option B:** Elevated fasting glucose is included in the NCEP ATP III criteria, making this option incorrect. **Option C:** High blood pressure is one of the defining characteristics of metabolic syndrome, so this option is not the correct answer. **Option D:** Low HDL cholesterol is included in the NCEP ATP III criteria, making this option incorrect. **Clinical Pearl / High-Yield Fact** To remember the NCEP ATP III criteria for metabolic syndrome, use the mnemonic "CENTRAL": Central obesity, Elevated fasting glucose, Triglycerides, NCEP ATP III blood pressure, Low HDL cholesterol. **Correct Answer:** D.