Prevalence of metabolic syndrome in two tribal populations of the sub-Himalayan region of India: Ethnic and rural–urban differences

Abstract

This study was undertaken to estimate prevalence of metabolic syndrome in traditional societies in the sub-Himalayan region and to assess the impact of modernization on the risk to the syndrome. Two tribal populations--Toto and Bhutia--with a shared ancestry and habitat were selected. Some Bhutians have adopted a modern lifestyle. The study design permitted assessment of the relative roles of lifestyle and genetic factors in influencing the prevalence of metabolic syndrome. Our study has revealed that metabolic syndrome (or its contributing variables) can be a major health problem, even in traditional rural ethnic groups, indicating that this syndrome is not necessarily a result of modernization or urbanization. Dyslipidemia seems to be the major contributor to metabolic syndrome. Further, our study indicates that genetic factors that adversely affect the levels of such variables have long antiquities in Indian ethnic groups. We find that there is an additional adverse impact of adoption of urban lifestyles (perhaps primarily mediated through dietary changes) on metabolic syndrome.

The prevalence of metabolic syndrome in South Asia: a systematic review

“…This systematic review examined a total of 16 studies comprising 14,515 males (44.1 %) and 18,390 females (55.9 %). Ten studies were conducted in India [12][13][14][15][16][17][18][19][20][21], two each in Sri Lanka [22,23] and Bangladesh [24,25] and one each in Pakistan [26] and Nepal [27]. Eight studies were carried out in urban settings [12-15, 18, 19, 21, 22], three in rural [24][25][26], four in both urban and rural [16,17,20,23], and one study did not mention setting [27].…”

“…Four studies used ATP III definition only [14,15,20,25], three studies considered modified ATP III definition only [13,18,21] and one study used IDF definition only [23]. Likewise, three studies followed ATP III and IDF definitions [16,26,27], one study followed modified ATP III and IDF definitions [22] and one study considered ATP III and modified ATP III definitions [17].…”

“…Nine studies [12-14, 16-19, 22, 27] provided all individual components of MS, whereas five [15,20,21,23,26] provided some of them, and two [24,25] provided none. Four studies [14,15,21,26] analysed individual components of MS by age group.…”

“…The prevalence range was 31.6 % [22] to 79.6 % [26]. In seven studies [12,14,17,20,23,26,27], low HDL cholesterol was found in more than half of the study participants. Eleven studies reported the prevalence by gender which provided weighted mean prevalence of 37.9 % for males and strikingly 68.8 % for females.…”

“…The weighted mean prevalence was marginally higher in males (37.2 %) than that in females (36.1 %). Eleven studies provided the prevalence of hypertriglyceridemia by gender; however, only three studies [19,20,26] showed higher prevalence of triglyceride in females. According to age groups, hypertriglyceridemia was mostly observed among participants in middle age of 40-60 years for both genders.…”