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      Age-specific prevalence of the metabolic syndrome defined by the International Diabetes Federation and the National Cholesterol Education Program: the Norwegian HUNT 2 study

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          Abstract

          Background

          The 2005 International Diabetes Federation (IDF) definition of the metabolic syndrome was designed to be useful worldwide, but to date few prevalence studies have used that definition in European populations. We estimated the age- and sex-stratified prevalence of IDF-defined metabolic syndrome in a county of Norway and compared it with the prevalence estimated using the revised National Cholesterol Education Program-Adult Treatment Panel-III definition (2005 ATP III).

          Methods

          Cross-sectional analysis of 10,206 participants aged 20–89 years in the Nord-Trøndelag Health Study 1995–97 (HUNT 2).

          Results

          Prevalence of IDF-defined metabolic syndrome was 29.6% (95% CI: 28.8 to 30.5), compared to 25.9% (95% CI: 25.0 to 26.7) using the 2005 ATP III criteria. The prevalence of IDF-defined metabolic syndrome increased from 11.0% in the 20–29 years age group to 47.2% in the 80–89 years group in men, and from 9.2% to 64.4% for women in the corresponding age groups. Among men and women aged ≥60 years, the IDF criteria classified 56.7% and 75.0%, respectively, as having central obesity, and 89.3% and 90.9%, respectively, as being hypertensive.

          Conclusion

          According to both definitions, the prevalence of the metabolic syndrome increased strongly with age. The IDF and the American Heart Association/National Heart, Lung, and Blood Institute guidelines for clinical management of metabolic syndrome would classify a high proportion of elderly Norwegians as in need of overall risk assessment for cardiovascular disease.

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          Most cited references25

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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.

          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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            Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the U.S.

            The International Diabetes Federation (IDF) has proposed a new definition of the metabolic syndrome that emphasizes central adiposity as determined by ethnic group-specific thresholds of waist circumference. The objective of this study was to estimate the prevalence of this syndrome using the IDF definition among U.S. adults and to compare it with the prevalence estimated using the definition of the National Cholesterol Education Program (NCEP). A total of 3,601 men and women aged > or =20 years from the National Health and Nutrition Examination Survey 1999-2002 were included in the analyses. Based on the NCEP definition, the unadjusted prevalence of the metabolic syndrome was 34.5 +/- 0.9% (percent +/- SE) among all participants, 33.7 +/- 1.6% among men, and 35.4 +/- 1.2% among women. Based on the IDF definition, the unadjusted prevalence of the metabolic syndrome was 39.0 +/- 1.1% among all participants, 39.9 +/- 1.7% among men, and 38.1 +/- 1.2% among women. The IDF definition led to higher estimates of prevalence in all of the demographic groups, especially among Mexican-American men. The two definitions similarly classified approximately 93% of the participants as having or not having the metabolic syndrome. In the U.S., the use of the IDF definition of the metabolic syndrome leads to a higher prevalence estimate of the metabolic syndrome than the estimate based on the NCEP definition.
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              Increasing prevalence of the metabolic syndrome among u.s. Adults.

              The prevalence of the metabolic syndrome is high among U.S. adults. Our purpose was to determine whether the prevalence of this syndrome has changed since 1988-1994. A total of 6,436 men and women aged > or = 20 years from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and 1,677 participants from NHANES 1999-2000 were included in the analyses. We used the definition of the metabolic syndrome developed by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. The unadjusted prevalence of the metabolic syndrome was 23.1% in NHANES III and 26.7% in NHANES 1999-2000 (P = 0.043), and the age-adjusted prevalences were 24.1 and 27.0% (P = 0.088), respectively. The age-adjusted prevalence increased by 23.5% among women (P = 0.021) and 2.2% among men (P = 0.831). Increases in high blood pressure, waist circumference, and hypertriglyceridemia accounted for much of the increase in the prevalence of the metabolic syndrome, particularly among women. The increased prevalence of the metabolic syndrome is likely to lead to future increases in diabetes and cardiovascular disease. Copyright 2004 American Diabetes Association
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central|1
                1471-2458
                2007
                29 August 2007
                : 7
                : 220
                Affiliations
                [1 ]Department of Psychiatry, Namsos Hospital, Namsos, Norway
                [2 ]Norwegian University of Science and Technology, Trondheim, Norway
                [3 ]Research Centre for Health Promotion, University of Bergen, Bergen, Norway
                [4 ]National Institute of Public Health, Division Epidemiology, Department of Mental Health, Oslo, Norway
                [5 ]Section of Cardiology, Department of Internal Medicine, Ålesund Hospital, Ålesund, Norway
                [6 ]HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Verdal, Norway
                [7 ]The Cancer Clinic, Rikshospitalet-Radiumhospitalet Medical Center, University of Oslo, Oslo, Norway
                Article
                1471-2458-7-220
                10.1186/1471-2458-7-220
                2048947
                17727697
                ed58699e-b093-42e9-a047-a7cb3b48331b
                Copyright © 2007 Hildrum et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 1 November 2006
                : 29 August 2007
                Categories
                Research Article

                Public health
                Public health

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