Prevalence of Metabolic Syndrome and Its Determinants in the Middle-aged and Elderly Population in A Southern Coastal Region, Iran (the PERSIAN Cohort Study): A Cross-sectional Study

Abstract

Background: Metabolic syndrome (MetS) criteria are different but interconnected cardiovascular risk factors, including dysglycemia, hypertension, abdominal obesity, and dyslipidemia. Objectives: We aimed to determine the prevalence of MetS, its components, and related factors in the south coastal area of Iran, Bandare-Kong non-communicable diseases (BKNCD). Methods: This population-based study was performed on the baseline data from participants of BKNCD, which has recruited participants from Bandare Kong city, one of the 18 distinct geographical areas included in the prospective epidemiological research studies in Iran (Persian). MetS was diagnosed based on the National Cholesterol Education Program (NCEP) criteria and the Iranian-specific cut-off for waist circumference (≥ 95 cm). The socioeconomic status (SES) was estimated by multiple correspondence analysis (MCA) based on participants’ different properties. Results: Of 3,927 participants included in this study, 2,230 (56.8%) were female. Age-standardized prevalence of MetS was 34.5%. The most common MetS component was central obesity (45.1%), followed by decreased high-density lipoprotein (42.6%), elevated fasting plasma glucose (39.9%), elevated triglyceride (37.7%), and increased blood pressure (37.5%). Besides, 84.7% of the subjects displayed at least one component of MetS. Binary logistic regression analysis revealed that women aged 65 - 70 years were at higher risk of having MetS compared to those aged 35 - 39 years (aOR = 12.37, 95% CI 7.54 - 20.30, P < 0.001). Also, living in rural areas was a risk for MetS in women (aOR = 1.55, 95% CI 1.18 - 2.03, P = 0.002). Employment and education were protective against MetS in women. Being overweight significantly increased the risk of MetS in both men and women. Obesity was more problematic for men (aOR = 16.66, 95% CI 11.65 - 23.81, P < 0.001) compared to women (aOR = 10.43, 95% CI 7.82 - 13.90, P < 0.001). Marital status, education, smoking status, and SES did not significantly predict MetS in men. Conclusions: A high prevalence of MetS was observed in this study, emphasizing central obesity, high TG, and low HDL. This calls on the government authorities to establish screening programs to identify individuals with a lower number of abnormal MetS components to prevent them from developing MetS and the resultant cardiovascular complications. Keywords PERSIAN Cohort Study Dysglycemia Abdominal Obesity Metabolic Syndrome