OBJECTIVE -To assess the relationship between household income and metabolic syndrome in men and women.RESEARCH DESIGN AND METHODS -A total of 1,695 men and 1,664 women, aged 35-64 years, from three distinct geographical areas of France were investigated. Waist girth, plasma triglycerides, HDL cholesterol, glucose, and systolic blood pressure were used to define metabolic syndrome according to the National Cholesterol Education Program (NCEP)/ Adult Treatment Panel III (ATPIII) guidelines. Household income, educational level, occupational category, working status, consumption of psychotropic drugs, accommodation status, household composition, physical activity at work and during leisure time, alcohol consumption, and smoking habits were recorded with a standardized questionnaire.RESULTS -There were 390 (23.0%) men and 381 (16.9%) women who satisfied NCEP/ ATPIII criteria for metabolic syndrome. Household income (P Ͻ 0.0001) and consumption of psychotropic drugs (P ϭ 0.0005) were associated with metabolic syndrome in women but not in men. In contrast, educational level, occupational category, working status, and accommodation status were associated with metabolic syndrome in both men and women. After adjustment on lifestyle variables, household income (interaction P Ͻ 0.004) remained inversely associated with metabolic syndrome in women but not in men.CONCLUSIONS -These data suggest that limited household income, which reflects a complex unfavorable social and economic environment, may increase the risk of metabolic syndrome in a sex-specific manner.
Diabetes Care 28:409 -415, 2005T he metabolic syndrome is characterized by the clustering of several metabolic disorders (1,2). The latter are influenced by nutritional habits and physical activity (3-6). Several working definitions have been proposed for metabolic syndrome (7), including increased body weight, insulin resistance, elevated plasma triglyceride levels, low HDL cholesterol, high blood pressure, and altered glucose homeostasis. These factors independently and in combination increase the risk of cardiovascular disease and diabetes (8 -11).In the U.S., the prevalence of metabolic syndrome has been estimated to be 22.8 and 22.6% in men and women, respectively (12). The distribution of the syndrome varies among different categories of the population. Increasing evidence (13-21) indicates that social indicators and psychological factors are strongly associated with the risk of insulin resistance, hypertriglyceridemia, hypertension, obesity, and metabolic syndrome. People from the lowest social categories are more likely to develop several metabolic disorders or metabolic syndrome. The mechanisms involved in these associations are not totally elucidated. Social factors, educational level, and economic indicators are strongly interrelated. These factors influence nutritional habits, physical activity, and healthy behaviors possibly affecting the clustering of metabolic disorders (22,23).Very little is known about the influence of household income on the risk of...