Elsevier

Metabolism

Volume 58, Issue 8, August 2009, Pages 1102-1108
Metabolism

Prevalence of metabolic syndrome and factors associated with its components in Chinese adults

https://doi.org/10.1016/j.metabol.2009.04.008Get rights and content

Abstract

The purpose of this study was to assess the prevalence of metabolic syndrome (MetS) and its components among middle-aged and elderly adults in Jiangsu province, China. Moreover, factors associated with MetS were also assessed. A population-based cross-sectional survey was conducted with 4 randomly selected areas including both urban and rural areas from Jiangsu province, China. After the procedure, 3914 adults aged 35 to 74 years were included in the study. Metabolic syndrome was defined by the modified National Cholesterol Education Program Adult Treatment Panel III report. Data were collected by interviewer-administered questionnaire, biophysical assessment, and biochemical examination. Crude and age-standardized prevalence of MetS was 31.5% and 30.5%, respectively. Prevalence rate increased significantly with age in female but not in male subjects, whereas this was true for both sexes with increased body mass index. High blood pressure was the most prevalent component of MetS (45.2%), followed by elevated triglycerides (40.1%) and low high-density lipoprotein cholesterol (40.1%). Multivariate ordinal regression analysis revealed that women had significantly higher risk of MetS than men (odds ratio = 1.72, P < .001). Older age, living in urban area, income, family history of diabetes, and family history of hypertension were positively associated with MetS risk. However, higher education and tea drinking everyday were found to be negatively associated with MetS (P < .05). Moreover, substantial agreement (κ = 0.79) was found between the International Diabetes Federation and modified Adult Treatment Panel III criteria among 3 comparisons of MetS definitions. Metabolic syndrome was highly prevalent in middle-aged and elderly Chinese population in Jiangsu province. Community-based strategies for diet and lifestyle modifications are strongly suggested, especially in women and the elderly.

Introduction

In the last 2 decades, a great deal of concern has been focused on a cluster of metabolic abnormalities including abdominal obesity, hyperglycemia, hypertension, and adipose metabolic disorder identified as metabolic syndrome (MetS). It is regarded as an independent risk factor of cardiovascular disease and type 2 diabetes mellitus [1], [2], [3]. Although debate on the use of the term metabolic syndrome is still going on [4], [5], its impact on public health has been considerable. Criteria proposed by the World Health Organization (WHO) [6], International Diabetes Federation (IDF) [7], and National Cholesterol Education Program Adult Treatment Panel III (ATP III) [8] were often used in publications.

Metabolic syndrome is becoming epidemic worldwide [7]. It is increasing rapidly in all ages and is considered one of the important public health challenges in China [9], [10], [11].

Nevertheless, the disparity in economic development is very large in China. Few studies on prevalence and determinants of MetS in China were done in economic booming areas. The current study was conducted in Jiangsu province, which is economically developed. It has a population of 74 million and has the highest population density in China. In the present study, our aims were to evaluate the prevalence of MetS and to assess the factors associated with MetS risk. This may serve as a basis to design necessary intervention programs for the prevention of cardiocerebrovascular diseases and diabetes.

Section snippets

Participants

This population-based study was conducted on a random sample of residents aged 35 to 74 years in urban and rural areas from Jiangsu province, China. Only 1 person was selected in each family to reduce the problem associated to clustering of some risk factors related to genetic predisposition, food habits, and environmental factors. Exclusion criteria were pregnant women, and physically or mentally disabled person unable to follow simple questions and examinations. Four investigation sites were

Basic characteristics of study sample

Description of anthropometric, metabolic, and lifestyle characteristics of 3914 subjects in the study according to the absence or presence of MetS are shown in Table 1. The mean age of the sample was 53.5 ± 10.9 years. Two thousand six hundred eighty subjects were free of MetS, whereas 1234 subjects had the syndrome. More women than men had MetS. The proportions of smoking, alcohol drinking, and tea drinking were significantly lower in the MetS group compared with the non-MetS group (P < .01).

Discussion

In the study, we found a high prevalence of MetS in a province with rapid economic development. A positive association between urban residence, high income, and MetS was found. Education level and tea drinking were inversely associated with MetS.

Our data showed that 30.5% of adult population aged 35 to 74 years residing in both urban and rural areas in Jiangsu province had MetS following the modified ATP III criteria. There was a noteworthy increase of MetS since 1992 when the prevalence was

Acknowledgment

This work was funded by the Norwegian Research Council, Norway. The authors appreciate the participation of the subjects from investigation sites and health professionals from Centers for Disease Prevention and Control and community health care centers in this study.

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