<P> Other signs of metabolic syndrome include high blood pressure, decreased fasting serum HDL cholesterol, elevated fasting serum triglyceride level (VLDL triglyceride), impaired fasting glucose, insulin resistance, or prediabetes . </P> <P> Associated conditions include hyperuricemia, fatty liver (especially in concurrent obesity) progressing to nonalcoholic fatty liver disease, polycystic ovarian syndrome (in women), erectile dysfunction (in men), and acanthosis nigricans . </P> <P> The exact mechanisms of the complex pathways of metabolic syndrome are under investigation . The pathophysiology is very complex and has been only partially elucidated . Most patients are older, obese, sedentary, and have a degree of insulin resistance . Stress can also be a contributing factor . The most important risk factors are diet (particularly sugar - sweetened beverage consumption), genetics, aging, sedentary behavior or low physical activity, disrupted chronobiology / sleep, mood disorders / psychotropic medication use, and excessive alcohol use . </P> <P> There is debate regarding whether obesity or insulin resistance is the cause of the metabolic syndrome or if they are consequences of a more far - reaching metabolic derangement . A number of markers of systemic inflammation, including C - reactive protein, are often increased, as are fibrinogen, interleukin 6, tumor necrosis factor - alpha (TNF - α), and others . Some have pointed to a variety of causes, including increased uric acid levels caused by dietary fructose . </P>

Which of the following conditions are signs of metabolic syndrome