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The MetS is a major health concern in the United States today being more prevalent in older individuals and in populations of specific racial/ethnic backgrounds. Although MetS is defined by a clustering of metabolic abnormalities including hyperglycemia, high blood pressure and central obesity, we propose the addition of pro-inflammatory adipokines (TNF-α, IL-6, Leptin, PAI-1) as well as CRP being incorporated into the physiological evaluation of those at risk for MetS. Much research exists to show that hyperinsulinemia and central obesity are integral to the development of MetS and that inflammatory adipokines and cytokines are increased in response to the development of insulin resistance and central obesity. However, questions remain as to whether or not these are the primary contributors or sole antecedents to the development of MetS. Androgenic steroids have also been proposed to contribute to the pathogenesis of MetS.  More research is necessary to determine whether insulin resistance and central obesity mediate the relationship between androgens and MetS or whether androgenic sex steroids mediate the relationship between MetS and insulin resistance and/or central obesity or whether there is bidirectionality in aforementioned relationships.