Skip to main content
Erschienen in: International Journal of Diabetes in Developing Countries 4/2011

01.12.2011 | Original Article

Prevalence of the metabolic syndrome in rural India—a disparity in definitions

verfasst von: Punith Kempegowda, Sara Rani Marcus, Priyank Solanki, Rashmi S. Reddy, Nandini D. R., Mala Dharmalingam

Erschienen in: International Journal of Diabetes in Developing Countries | Ausgabe 4/2011

Einloggen, um Zugang zu erhalten

Abstract

Although the metabolic syndrome is a known predictor of coronary heart disease and type-2 diabetes mellitus, it has no agreed definition. The concordance of its various definitions has been studied for a limited number of populations and there are few studies on the rural populations in India. The present study was done to determine the prevalence of metabolic syndrome in a rural population of South India and to evaluate the concordance of the modified National Cholesterol Education Programme-Adult Treatment Panel III definition and International Diabetes Federation definition for the diagnosis of Metabolic Syndrome. Anthropometric and biochemical parameters (fasting blood glucose and lipid profile) and blood pressure were measured using standard procedures. The prevalence of metabolic syndrome was calculated using the two sets of criteria and compared for their concordance. Descriptive statistics was used to analyze age and risk factors of metabolic syndrome. The chi-square test was applied to compare the prevalence of metabolic syndrome obtained from the two criteria (significant if p < 0.05). An inter-rater reliability analysis using the kappa statistic was performed to determine consistency between the two sets of criteria in diagnosing the metabolic syndrome. The modified National Cholesterol Education Programme-Adult Treatment Panel III definition and International Diabetes Federation definition for metabolic syndrome identified overall age-adjusted prevalence of 17.8% and 20.5% respectively, which were not significantly different. Kappa statistics revealed only moderate agreement of 0.44 between the two sets of criteria. The impact of economic development and preponderance of genetic factors is increasing the prevalence of metabolic syndrome in rural India. It is important to determine which definition of the metabolic syndrome best predicts coronary heart disease and type 2 diabetes in this population in order to formulate effective public health policy.
Literatur
1.
Zurück zum Zitat National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143–421. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143–421.
2.
Zurück zum Zitat Reddy KS, Yusuf S. Emerging epidemic of cardiovascular disease in developing countries. Circulation. 1998;97:596–601.PubMed Reddy KS, Yusuf S. Emerging epidemic of cardiovascular disease in developing countries. Circulation. 1998;97:596–601.PubMed
3.
Zurück zum Zitat Ghaffar A, Reddy KS, Singhi M. Burden of non-communicable diseases in South Asia. BMJ. 2004;328:807–10.PubMedCrossRef Ghaffar A, Reddy KS, Singhi M. Burden of non-communicable diseases in South Asia. BMJ. 2004;328:807–10.PubMedCrossRef
4.
Zurück zum Zitat Joshi R, Cardona M, Iyengar S, Sukumar A, Raju CR, Raju KR, et al. Chronic diseases now a leading cause of death in rural India—mortality data from Andhra Pradesh Health Initiative. Int J Epidemiol. 2006;35:1522–9.PubMedCrossRef Joshi R, Cardona M, Iyengar S, Sukumar A, Raju CR, Raju KR, et al. Chronic diseases now a leading cause of death in rural India—mortality data from Andhra Pradesh Health Initiative. Int J Epidemiol. 2006;35:1522–9.PubMedCrossRef
6.
Zurück zum Zitat Deepa M, Farooq S, Datta M, Deepa R, Mohan V. Prevalence of metabolic syndrome using WHO, ATPIII and IDF definitions in Asian Indians: the Chennai Urban Rural Epidemiology Study (CURES-34). Diabetes Metab Res Rev. 2007;23:127–34.PubMedCrossRef Deepa M, Farooq S, Datta M, Deepa R, Mohan V. Prevalence of metabolic syndrome using WHO, ATPIII and IDF definitions in Asian Indians: the Chennai Urban Rural Epidemiology Study (CURES-34). Diabetes Metab Res Rev. 2007;23:127–34.PubMedCrossRef
7.
Zurück zum Zitat Prabhakaran D, Chaturvedi V, Shah P, Manhapra A, Jeemon P, Shah B, et al. Differences in the prevalence of metabolic syndrome in urban and rural India: a problem of urbanization. Chronic Illn. 2007;3:8–19.PubMedCrossRef Prabhakaran D, Chaturvedi V, Shah P, Manhapra A, Jeemon P, Shah B, et al. Differences in the prevalence of metabolic syndrome in urban and rural India: a problem of urbanization. Chronic Illn. 2007;3:8–19.PubMedCrossRef
9.
Zurück zum Zitat Balkau B, Charles MA. Comment on the provisional report from the WHO consultation. European Group for the Study of Insulin Resistance (EGIR). Diabet Med. 1999;16:442–3.PubMedCrossRef Balkau B, Charles MA. Comment on the provisional report from the WHO consultation. European Group for the Study of Insulin Resistance (EGIR). Diabet Med. 1999;16:442–3.PubMedCrossRef
10.
Zurück zum Zitat Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285:2486–97.CrossRef Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285:2486–97.CrossRef
11.
Zurück zum Zitat Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112:2735–52.PubMedCrossRef Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112:2735–52.PubMedCrossRef
12.
Zurück zum Zitat Alberti KG, Zimmet P, Shaw J, IDF Epidemiology Task Force Consensus Group. The metabolic syndrome—a new worldwide definition. Lancet. 2005;366:1059–62.PubMedCrossRef Alberti KG, Zimmet P, Shaw J, IDF Epidemiology Task Force Consensus Group. The metabolic syndrome—a new worldwide definition. Lancet. 2005;366:1059–62.PubMedCrossRef
13.
Zurück zum Zitat Lee CM, Huxley RR, Woodward M, Zimmet P, Shaw J, Cho NH, et al. Detect-2 collaboration: Comparisons of metabolic syndrome definitions in four populations of the Asia-Pacific region. Metab Syndr Relat Disord. 2008;6:37–46.PubMedCrossRef Lee CM, Huxley RR, Woodward M, Zimmet P, Shaw J, Cho NH, et al. Detect-2 collaboration: Comparisons of metabolic syndrome definitions in four populations of the Asia-Pacific region. Metab Syndr Relat Disord. 2008;6:37–46.PubMedCrossRef
14.
Zurück zum Zitat Guerrero-Romero F, Rodríguez-Morán M. Concordance between the 2005 International Diabetes Federation definition for diagnosing metabolic syndrome with the National Cholesterol Education Program Adult Treatment Panel III and the World Health Organization definitions. Diabetes Care. 2005;28:2588–9.PubMedCrossRef Guerrero-Romero F, Rodríguez-Morán M. Concordance between the 2005 International Diabetes Federation definition for diagnosing metabolic syndrome with the National Cholesterol Education Program Adult Treatment Panel III and the World Health Organization definitions. Diabetes Care. 2005;28:2588–9.PubMedCrossRef
15.
Zurück zum Zitat Can AS, Bersot TP. Analysis of agreement among definitions of metabolic syndrome in nondiabetic Turkish adults: a methodological study. BMC Publ Health. 2007;19:353.CrossRef Can AS, Bersot TP. Analysis of agreement among definitions of metabolic syndrome in nondiabetic Turkish adults: a methodological study. BMC Publ Health. 2007;19:353.CrossRef
16.
Zurück zum Zitat Kelliny C, William J, Riesen W, Bovet P. Metabolic syndrome according to different definitions in a rapidly developing country of the African region. Cardiovasc Diabetol. 2008;7:27.PubMedCrossRef Kelliny C, William J, Riesen W, Bovet P. Metabolic syndrome according to different definitions in a rapidly developing country of the African region. Cardiovasc Diabetol. 2008;7:27.PubMedCrossRef
17.
Zurück zum Zitat Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.PubMedCrossRef Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.PubMedCrossRef
18.
Zurück zum Zitat Mahadik SR, Deo SS, Mehtalia SD. Increased prevalence of metabolic syndrome in non-obese Asian Indian—an urban-rural comparison. Metab Syndr Relat Disord. 2007;5:142–52.PubMedCrossRef Mahadik SR, Deo SS, Mehtalia SD. Increased prevalence of metabolic syndrome in non-obese Asian Indian—an urban-rural comparison. Metab Syndr Relat Disord. 2007;5:142–52.PubMedCrossRef
19.
Zurück zum Zitat Qiao Q, DECODE Study Group. Comparison of different definitions of the metabolic syndrome in relation to cardiovascular mortality in European men and women. Diabetologia. 2006;49:2837–46.PubMedCrossRef Qiao Q, DECODE Study Group. Comparison of different definitions of the metabolic syndrome in relation to cardiovascular mortality in European men and women. Diabetologia. 2006;49:2837–46.PubMedCrossRef
20.
Zurück zum Zitat Balkau B. The DECODE study. Diabetes epidemiology: collaborative analysis of diagnostic criteria in Europe. Diabetes Metab. 2000;26:282–6.PubMed Balkau B. The DECODE study. Diabetes epidemiology: collaborative analysis of diagnostic criteria in Europe. Diabetes Metab. 2000;26:282–6.PubMed
21.
Zurück zum Zitat Adegoke OA, Adedoyin RA, Balogun MO, Adebayo RA, Bisiriyu LA, Salawu AA. Prevalence of metabolic syndrome in a rural community in Nigeria. Metab Syndr Relat Disord. 2010;8:59–62.PubMedCrossRef Adegoke OA, Adedoyin RA, Balogun MO, Adebayo RA, Bisiriyu LA, Salawu AA. Prevalence of metabolic syndrome in a rural community in Nigeria. Metab Syndr Relat Disord. 2010;8:59–62.PubMedCrossRef
22.
Zurück zum Zitat Vaughan C, Schoo A, Janus ED, Philpot B, Davis-Lameloise N, Lo SK, et al. The association of levels of physical activity with metabolic syndrome in rural Australian adults. BMC Publ Health. 2009;9:273.CrossRef Vaughan C, Schoo A, Janus ED, Philpot B, Davis-Lameloise N, Lo SK, et al. The association of levels of physical activity with metabolic syndrome in rural Australian adults. BMC Publ Health. 2009;9:273.CrossRef
23.
Zurück zum Zitat Redmon JB, Bertoni AG, Connelly S, Fenney PA, Glasser S, Glick H, et al. Effect of the Look AHEAD Study intervention on medication use and related cost to treat cardiovascular disease risk factors in individuals with type 2 diabetes. Diabetes Care. 2010;33:1153–8.PubMedCrossRef Redmon JB, Bertoni AG, Connelly S, Fenney PA, Glasser S, Glick H, et al. Effect of the Look AHEAD Study intervention on medication use and related cost to treat cardiovascular disease risk factors in individuals with type 2 diabetes. Diabetes Care. 2010;33:1153–8.PubMedCrossRef
24.
Zurück zum Zitat Misra A, Khurana L. The metabolic syndrome in South Asians: epidemiology, determinants, and prevention. Metab Syndr Relat Disord. 2009;7:497–514.PubMedCrossRef Misra A, Khurana L. The metabolic syndrome in South Asians: epidemiology, determinants, and prevention. Metab Syndr Relat Disord. 2009;7:497–514.PubMedCrossRef
25.
Zurück zum Zitat Enas EA, Mohan V, Deepa M, Farooq S, Pazhoor S, Chennikkara H. The metabolic syndrome and dyslipidemia among Asian Indians: a population with high rates of diabetes and premature coronary artery disease. J Cardiometab Syndr. 2007;2:267–75.PubMedCrossRef Enas EA, Mohan V, Deepa M, Farooq S, Pazhoor S, Chennikkara H. The metabolic syndrome and dyslipidemia among Asian Indians: a population with high rates of diabetes and premature coronary artery disease. J Cardiometab Syndr. 2007;2:267–75.PubMedCrossRef
26.
Zurück zum Zitat Morimoto A, Nishimura R, Suzuki N, Matsudaira T, Taki K, Tsujino D, et al. Low prevalence of metabolic syndrome and its components in rural Japan. Tohoku J Exp Med. 2008;216:69–75.PubMedCrossRef Morimoto A, Nishimura R, Suzuki N, Matsudaira T, Taki K, Tsujino D, et al. Low prevalence of metabolic syndrome and its components in rural Japan. Tohoku J Exp Med. 2008;216:69–75.PubMedCrossRef
27.
Zurück zum Zitat Zuo H, Shi Z, Hu X, Wu M, Guo Z, Hussain A. Prevalence of metabolic syndrome and factors associated with its components in Chinese adults. Metabolism. 2009;58:1102–8.PubMedCrossRef Zuo H, Shi Z, Hu X, Wu M, Guo Z, Hussain A. Prevalence of metabolic syndrome and factors associated with its components in Chinese adults. Metabolism. 2009;58:1102–8.PubMedCrossRef
28.
Zurück zum Zitat Ntandou G, Delisle H, Agueh V, Fayomi B. Abdominal obesity explains the positive rural-urban gradient in the prevalence of the metabolic syndrome in Benin, West Africa. Nutr Res. 2009;29:180–9.PubMedCrossRef Ntandou G, Delisle H, Agueh V, Fayomi B. Abdominal obesity explains the positive rural-urban gradient in the prevalence of the metabolic syndrome in Benin, West Africa. Nutr Res. 2009;29:180–9.PubMedCrossRef
29.
Zurück zum Zitat Basit A, Shera AS. Prevalence of metabolic syndrome in Pakistan. Metab Syndr Relat Disord. 2008;6:171–5.PubMedCrossRef Basit A, Shera AS. Prevalence of metabolic syndrome in Pakistan. Metab Syndr Relat Disord. 2008;6:171–5.PubMedCrossRef
30.
Zurück zum Zitat Chow CK, Naidu S, Raju K, Raju R, Joshi R, Sullivan D, et al. Significant lipid, adiposity and metabolic abnormalities amongst 4535 Indians from a developing region of rural Andhra Pradesh. Atherosclerosis. 2008;196:943–52.PubMedCrossRef Chow CK, Naidu S, Raju K, Raju R, Joshi R, Sullivan D, et al. Significant lipid, adiposity and metabolic abnormalities amongst 4535 Indians from a developing region of rural Andhra Pradesh. Atherosclerosis. 2008;196:943–52.PubMedCrossRef
31.
Zurück zum Zitat Rahim MA, Khan AK, Sayeed MA, Akhtar B, Nahar Q, Ali SMK, et al. Metabolic syndrome in rural Bangladesh: comparison of newly proposed IDF, modified ATP III and WHO criteria and their agreements. Diabetes Metab Syndr Clin Res Rev. 2007;1:251–7.CrossRef Rahim MA, Khan AK, Sayeed MA, Akhtar B, Nahar Q, Ali SMK, et al. Metabolic syndrome in rural Bangladesh: comparison of newly proposed IDF, modified ATP III and WHO criteria and their agreements. Diabetes Metab Syndr Clin Res Rev. 2007;1:251–7.CrossRef
32.
Zurück zum Zitat Hydrie MZ, Shera AS, Fawwad A, Basit A, Hussain A. Prevalence of metabolic syndrome in urban Pakistan (Karachi): comparison of newly proposed International Diabetes Federation and modified Adult Treatment Panel III criteria. Metab Syndr Relat Disord. 2009;7:119–24.PubMedCrossRef Hydrie MZ, Shera AS, Fawwad A, Basit A, Hussain A. Prevalence of metabolic syndrome in urban Pakistan (Karachi): comparison of newly proposed International Diabetes Federation and modified Adult Treatment Panel III criteria. Metab Syndr Relat Disord. 2009;7:119–24.PubMedCrossRef
33.
Zurück zum Zitat Mangat C, Goel NK, Walia DK, Agarwal N, Sharma MK, Kaur J, et al. Metabolic syndrome: a challenging health issue in highly urbanized Union territory of North India. Diabetol Metab Syndr. 2010;2:19.PubMedCrossRef Mangat C, Goel NK, Walia DK, Agarwal N, Sharma MK, Kaur J, et al. Metabolic syndrome: a challenging health issue in highly urbanized Union territory of North India. Diabetol Metab Syndr. 2010;2:19.PubMedCrossRef
Metadaten
Titel
Prevalence of the metabolic syndrome in rural India—a disparity in definitions
verfasst von
Punith Kempegowda
Sara Rani Marcus
Priyank Solanki
Rashmi S. Reddy
Nandini D. R.
Mala Dharmalingam
Publikationsdatum
01.12.2011
Verlag
Springer-Verlag
Erschienen in
International Journal of Diabetes in Developing Countries / Ausgabe 4/2011
Print ISSN: 0973-3930
Elektronische ISSN: 1998-3832
DOI
https://doi.org/10.1007/s13410-011-0046-y

Weitere Artikel der Ausgabe 4/2011

International Journal of Diabetes in Developing Countries 4/2011 Zur Ausgabe