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Abstract: Aims: The metabolic syndrome (MS) and type 2 diabetes mellitus (T2DM) are common in Asian Indians. Simple yet reliable phenotypic markers are needed for early detection of the MS in Asian Indians. Methods: In this cross-sectional study, 126 subjects either with of without the MS were compared. Anthropometric measurements (including assessment of novel phenotypic markers) and metabolic profile were done. Results: On univariate analysis, age more than 35 year, female gender, presence of buffalo hump and double chin and family history of T2DM were significantly associated with the MS. A metabolic syndrome screening (MSS) score (1.0×double chin+1.2×buffalo hump+1.3×gender+1.4×age category) was generated with a cutoff value of 3.5 out of total points of 4.9, with sensitivity and specificity 82% and 71% [area under the curve=0.83; 95% confidence Interval (0.76–0.90)], respectively in detecting individuals with the MS. Conclusion: We describe buffalo hump and double chin as novel phenotypic markers for detection of MS for the first time. The MSS score generated by us may be a useful tool for detection of MS in adult Asian Indians; however, it needs further validation in a larger sample of Asian Indians and in other ethnic groups. [Copyright &y& Elsevier]