Background: Research on metabolic syndrome (MetS) in young women within the Eastern Mediterranean is limited. This study assessed MetS prevalence and risk factors among female pharmacy students in Syria, while evaluating the diagnostic utility of the Triglyceride-Glucose (TyG) index and small dense LDL-C (sdLDL-C).

Methods: A cross-sectional study was conducted with 129 women (ages 20–30) at Arab International University. MetS was defined by International Diabetes Federation (IDF) criteria. Data collection included structured questionnaires, anthropometric measurements, and fasting blood analysis.

Results: The prevalence of MetS was 7.0%. Central obesity (waist circumference ≥80 cm) was the most common risk factor, present in 100% of MetS cases, followed by elevated blood pressure and low HDL-C. Notable lifestyle risks included physical inactivity (50.39%) and frequent fast-food consumption (34.11%). Participants with at least one MetS risk factor had significantly higher TyG index (8.9 vs. 8.02, p=0.003) and sdLDL-C levels (35.2 vs. 26.13 mg/dL, p=0.007) than those with no risk factors. The TyG index correlated strongly with triglycerides (r=0.83) and sdLDL-C (r=0.59).

Conclusion: Young Syrian women face a significant burden of metabolic risk associated with sedentary lifestyles. The TyG index is a simple, cost-effective tool for early insulin resistance screening. Integrating these biomarkers into routine clinical practice could improve early detection and prevention strategies in high-risk populations.