The Prevalence of Metabolic Syndrome and Its Related Factors among Adults in Palestine: A Meta-Analysis

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Abstract

Background

Metabolic syndrome (MetS)is increasingly becoming a challenging public health issue in Palestine. The current burden of MetS in the country is unknown. There has been limited research on the prevalence of MetS. This meta-analysis is the first to estimate the population prevalence of MetS and its related factors among adults in Palestine.

Methods

A PRISMA systematic search appraisal and meta-analysis were conducted. A systematic literature search of PubMed, Scopus and Google Scholar was conducted in December 2014 up to February 2015. Generic, methodological and statistical data was extracted from the eligible studies which reported MetS prevalence. A random effect meta-analysis was conducted on crude MetS prevalence rates. Heterogeneity was assessed by Cochran's Q and I ² tests. Subgroup analyses were also performed according to the predefined criteria.

Results

The literature search yielded a total of 49 studies. Eight papers were included in the final analysis with sample size ranging 163 to 992. In addition, 2937 cases with MetS among people aged 15 years or more were estimated in Palestine between 2001 and 2014. There was high heterogeneity among studies (I ² = 95.8% p<0.001). The prevalence of MetS was 37.0% among adult Palestinians population ranging from 17 to 59.5%. Subgroup analysis did not show source of heterogeneity based on subject's health status and MetS criteria.

Conclusion

Our meta-analysis clearly demonstrates that MetS is highly prevalent (37.0%) among Palestinian adults. The high prevalence of MetS in Palestine should be seriously considered and planners should take steps to reduce it.

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Most cited references 33

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The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994.

Yong-Woo Park, Shankuan Zhu, Latha P. Palaniappan … (2003)

The metabolic syndrome is an important cluster of coronary heart disease risk factors with common insulin resistance. The extent to which the metabolic syndrome is associated with demographic and potentially modifiable lifestyle factors in the US population is unknown. Metabolic syndrome-associated factors and prevalence, as defined by Adult Treatment Panel III criteria, were evaluated in a representative US sample of 3305 black, 3477 Mexican American, and 5581 white men and nonpregnant or lactating women aged 20 years and older who participated in the cross-sectional Third National Health and Nutrition Examination Survey. The metabolic syndrome was present in 22.8% and 22.6% of US men and women, respectively (P =.86). The age-specific prevalence was highest in Mexican Americans and lowest in blacks of both sexes. Ethnic differences persisted even after adjusting for age, body mass index, and socioeconomic status. The metabolic syndrome was present in 4.6%, 22.4%, and 59.6% of normal-weight, overweight, and obese men, respectively, and a similar distribution was observed in women. Older age, postmenopausal status, Mexican American ethnicity, higher body mass index, current smoking, low household income, high carbohydrate intake, no alcohol consumption, and physical inactivity were associated with increased odds of the metabolic syndrome. The metabolic syndrome is present in more than 20% of the US adult population; varies substantially by ethnicity even after adjusting for body mass index, age, socioeconomic status, and other predictor variables; and is associated with several potentially modifiable lifestyle factors. Identification and clinical management of this high-risk group is an important aspect of coronary heart disease prevention.

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Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome.

Darcy B Carr, Kristina Utzschneider, Rebecca Hull … (2004)

The underlying pathophysiology of the metabolic syndrome is the subject of debate, with both insulin resistance and obesity considered as important factors. We evaluated the differential effects of insulin resistance and central body fat distribution in determining the metabolic syndrome as defined by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III. In addition, we determined which NCEP criteria were associated with insulin resistance and central adiposity. The subjects, 218 healthy men (n = 89) and women (n = 129) with a broad range of age (26-75 years) and BMI (18.4-46.8 kg/m2), underwent quantification of the insulin sensitivity index (Si) and intra-abdominal fat (IAF) and subcutaneous fat (SCF) areas. The metabolic syndrome was present in 34 (15.6%) of subjects who had a lower Si [median: 3.13 vs. 6.09 x 10(-5) min(-1)/(pmol/l)] and higher IAF (166.3 vs. 79.1 cm2) and SCF (285.1 vs. 179.8 cm2) areas compared with subjects without the syndrome (P < 0.001). Multivariate models including Si, IAF, and SCF demonstrated that each parameter was associated with the syndrome. However, IAF was independently associated with all five of the metabolic syndrome criteria. In multivariable models containing the criteria as covariates, waist circumference and triglyceride levels were independently associated with Si and IAF and SCF areas (P < 0.001). Although insulin resistance and central body fat are both associated with the metabolic syndrome, IAF is independently associated with all of the criteria, suggesting that it may have a pathophysiological role. Of the NCEP criteria, waist circumference and triglycerides may best identify insulin resistance and visceral adiposity in individuals with a fasting plasma glucose <6.4 mmol/l.

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Does the metabolic syndrome improve identification of individuals at risk of type 2 diabetes and/or cardiovascular disease?

M Stern, K. Williams, C González-Villalpando … (2004)

The metabolic syndrome has been promoted as a method for identifying high-risk individuals for type 2 diabetes and cardiovascular disease (CVD). We therefore sought to compare this syndrome, as defined by the National Cholesterol Education Program, to the Diabetes Predicting Model and the Framingham Risk Score as predictors of type 2 diabetes and CVD, respectively. A population-based sample of 1,709 initially nondiabetic San Antonio Heart Study (SAHS) participants were followed for 7.5 years, 195 of whom developed type 2 diabetes. Over the same time interval, 156 of 2,570 SAHS participants experienced a cardiovascular event. A population-based sample of 1,353 initially nondiabetic Mexico City Diabetes Study (MCDS) participants were followed for 6.5 years, 125 of whom developed type 2 diabetes. Baseline measurements included medical history, age, sex, ethnicity, smoking status, BMI, blood pressure, fasting and 2-h plasma glucose levels, and fasting serum total and HDL cholesterol and triglycerides. The sensitivities for predicting diabetes with the metabolic syndrome were 66.2 and 62.4% in the SAHS and the MCDS, respectively, and the false-positive rates were 27.8 and 38.7%, respectively. The sensitivity and false-positive rates for predicting CVD with the metabolic syndrome in the SAHS were 67.3 and 34.2%, respectively. At corresponding false-positive rates, the two predicting models had significantly higher sensitivities and, at corresponding sensitivities, significantly lower false-positive rates than the metabolic syndrome for both end points. Combining the metabolic syndrome with either predicting model did not improve the prediction of either end point. The metabolic syndrome is inferior to established predicting models for either type 2 diabetes or CVD.

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Author and article information

Journal

Journal ID (nlm-ta): Ethiop J Health Sci

Journal ID (iso-abbrev): Ethiop J Health Sci

Title: Ethiopian Journal of Health Sciences

Publisher: Research and Publications Office of Jimma University (Jimma, Ethiopia )

ISSN (Print): 1029-1857

ISSN (Electronic): 2413-7170

Publication date (Print): January 2017

Volume: 27

Issue: 1

Pages: 77-84

Affiliations

[1 ]Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences - International Campus IC-TUMS) Tehran, Iran

[2 ]Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

[3 ]Public Health Nutrition Research Group, Rowett Institute of Nutrition and Health, Aberdeen University, Aberdeen, Scotland, UK

Author notes

Funding: None

Competing Interests: The authors declare that this manuscript was approved by all authors in its form and that no competing interest exists.

kdjafarian@ 123456tums.ac.ir

Article

Publisher ID: jEJHS.v27.i1.pg77

DOI: 10.4314/ejhs.v27i1.10

PMC ID: 5390231

PubMed ID: 28458493

SO-VID: 9555c124-5e63-4647-b848-691709e7d8d4

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

The Prevalence of Metabolic Syndrome and Its Related Factors among Adults in Palestine: A Meta-Analysis

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Abstract

Background

Methods

Results

Conclusion

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Journal of Health Sciences

Most cited references 33

The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994.

Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome.

Does the metabolic syndrome improve identification of individuals at risk of type 2 diabetes and/or cardiovascular disease?

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