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

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.

Metabolic Syndrome in Urban and Rural Population of Greater Noida National Capital Region of India

“…Higher prevalence of the MetS among women found in the current study could be attributed to the nature of the work as most of the women do household work that includes less physical activity [27][28][29]. In fact, the urban population (both male and female) had a higher prevalence rate of MetS compared to rural counterpart which could be the outcome of their eating habit, stress, and sedentary lifestyle [10,26,30].…”

“…Venous blood samples were collected from the subjects in the morning after an overnight fast (8-10 h). Plasma fasting blood glucose (FBG) was measured using glucose oxidase-peroxidase method [10]. Cholesterol and triglycerides were measured using enzymatic cholesterol oxidase-peroxidase and glycerophosphate-oxidase (PAP) method, respectively [11,12].…”

“…India is an agricultural based country where people living in rural areas are mostly involved in the agricultural activities which are predicted to have a low incidence of MetS. Contrary to the belief, studies conducted in various regions of India portraying a different figure [10][11][12]. The capital of India, Delhi is a metropolitan city which has its influence on the adjacent rural territories.…”

Pathogenetic Mechanism of Type 2 Diabetes Mellitus and its Clinical Implications

“…Variations in the definitions have led to difficulties in determining the prevalence of metabolic syndrome in the population. 2 In the progression of metabolic syndrome to T2DM, there are inherent genetic factors, like polymorphism of the apolipoprotein E4, aldose reductase, angiotensin converting enzyme, and toll receptor genes. The initiating events include inflammation, oxidative stress, activation of protein kinase C, selectins, vascular cell adhesion molecules and interleukins, tumor necrosis factor α and nuclear factor kappa β (NF-κB) and nitrotyrosine.…”

Metabolic syndrome

“…The study by Puneet Gowda et al [11] is unique in that the same rural population of south India in Karnataka was studied both by modified National Cholesterol Education Programme-Adult Treatment Panel III definition and International Diabetes Federation criteria for the diagnosis of Metabolic Syndrome to evaluate the concordance or discordance of the diagnosis. There was significant discordance in the prevalence of metabolic syndrome using two criteria.…”