Abstract
The aim of the study is to assess the prevalence of metabolic syndrome (MetS) in Spain using specific cutoff points for waist circumference (WC) (>94.5 cm for men and >89.5 cm for women) and evaluating the influence of several socio-demographic and economic factors. Data on MetS were obtained from a national study of 4,727 subjects from 18 to 90 years of age, conducted in Spain between 2009 and 2010 (The di@bet.es study). MetS was defined applying the new Harmonized definition (evaluating the use of abdominal obesity (AO) as a obligatory criterion for MetS or not) as well as with other widely used criteria. Results were then compared with data from previous studies. Multiple logistic regression models were used to evaluate the influence of different social factors. The age-standardized MetS prevalence was 38.37 % (CI 35.74–40.99) in men and 29.62 % (CI 27.56–31.69) in women, when AO was required as a diagnostic criterion; 42.13 % (CI 39.37–44.89) and 32.31 % (CI 30.15–34.47) in men and women, respectively, if AO was not considered mandatory. Prevalence of MetS increased with age (p < 0.001 for trend). Women with a lower educational level were more likely to have MetS (OR 4.4; 95 % CI: 2.84-6.7) as compared with those with a higher educational level. Subjects with MetS had a worse physical quality of life. The combination of AO, hypertension and carbohydrate alterations was the most common MetS’ pattern. A high prevalence of MetS was detected in the Spanish population especially in men, the elderly and women with a low educational level.
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Fernádez-Bergés D, Cabrera de León A, Sanz H, Elosua R, Guembe MJ, Alzamora M, Vega-Alonso T, Félix-Redondo FJ, Ortiz-Marrón H, Rigo F, Lama C, Gavrila D, Segura-Fragoso A, Lozano L, Marrugat J (2012) Metabolic syndrome in Spain: prevalence and coronary risk associated with harmonized definition and WHO proposal. DARIOS study. Rev Esp Cardiol 65:241–248
Eckel RH, Grundy SM, Zimmet PZ (2005) The metabolic syndrome. Lancet 365:1415–1428
Lean ME, Han TS, Morrison CE (1995) Waist circumference as a measure for indicating need for weight management. BMJ 311:158–161
Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC Jr; International Diabetes Federation Task Force on Epidemiology and Prevention; Hational Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; International Association for the Study of Obesity (2009) Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120:1640–1645
Martínez-Larrad MT, Fernández-Pérez C, Corbatón-Anchuelo A, Gabriel R, Lorenzo C, Serrano-Ríos M (2011) Revised waist circumference cut-off points for the criteria of abdominal obesity in the Spanish population: multicenter nationwide Spanish population based study. Av Diabetol 27:168–174
Hara K, Matsushita Y, Horikoshi M, Yoshiike N, Yokoyama T, Tanaka H, Kadowaki T (2006) A proposal for the cutoff point of waist circumference for the diagnosis of metabolic syndrome in the Japanese population. Diabetes Care 29:1123–1124
Delavari A, Forouzanfar MH, Alikhani S, Sharifian A, Kelishadi R (2009) First nationwide study of the prevalence of the metabolic syndrome and optimal cutoff points of waist circumference in the Middle East: the national survey of risk factors for noncommunicable diseases of Iran. Diabetes Care 32:1092–1097
Alegría E, Cordero A, Laclaustra M, Grima A, León M, Casasnovas JA, Luengo E, del Río A, Ferreira I (2005) Investigadores del registro MESYAS. Prevalence of metabolic syndrome in the Spanish working population: mESYAS registry. Rev Esp Cardiol 58:797–806
Soriguer F, Goday A, Bosch-Comas A, Bordiú E, Calle-Pascual A, Carmena R, Casamitjana R, Castaño L, Castell C, Catalá M, Delgado E, Franch J, Gaztambide S, Girbés J, Gomis R, Gutiérrez G, López-Alba A, Martínez-Larrad MT, Menéndez E, Mora-Peces I, Ortega E, Pascual-Manich G, Rojo-Martínez G, Serrano-Rios M, Valdés S, Vázquez JA, Vendrell J (2012) Prevalence of diabetes mellitus and impaired glucose regulation in Spain: the di@bet.es study. Diabetologia 55:88–93
Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F, American Heart Association, National Heart, Lung, and Blood Institute (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 112:2735–2752
Alberti KG, Zimmet P, Shaw J, IDF Epidemiology Task Force Consensus Group (2005) The metabolic syndrome-a new worldwide definition. Lancet 366:1059
Vilagut G, Valderas JM, Feerer M, Garin O, López García E, Alonso J (2008) Interpretation of SF-36 and SF-12 questionnaires in Spain: physical and mental components. Med Clin (Barc) 130:726–735
Spanish National Statistics Institute. http://www.ine.es/. Accessed 30 Sept 2012
Cameron AJ, Shaw JE, Zimmet PZ (2004) The metabolic syndrome: prevalence in worldwide populations. Endocrinol Metab Clin North Am 33:351–375
Hu G, Qiao Q, Tuomilehto J, Balkau B, Borch-Johnsen K, Pyorala K, DECODE Study Group (2004) Prevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. Arch Intern Med 164:1066–1076
Ford ES, Giles WH, Dietz WH (2002) Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 287:356–359
Ford ES, Giles WH, Mokdad AH (2004) Increasing prevalence of the metabolic syndrome among US adults. Diabetes Care 27:2444–2449
Hildrum B, Mykletun A, Hole T, Midthjell K, Dahl AA (2007) Age-specific prevalence of the metabolic syndrome defined by the International Diabetes Federation and the National Cholesterol Education Program: the Norwegian HUNT 2 study. BMC Public Health 7:220. doi:10.1186/1471-2458-7-220. Accessed 1st Sept 2012
Ford ES, Li C, Zhao G (2010) Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US. J Diabetes 2:180–193
Gutiérrez-Fisac JL, Guallar-Castillón P, León-Muñoz LM, Graciani A, Banegas JR, Rodríguez-Artalejo F (2012) Prevalence of general and abdominal obesity in the adult population of Spain, 2008–2010: the ENRICA study. Obes Rev 13:388–392
Brunner EJ, Marmot MG, Nanchahal K, Shipley MJ, Stansfeld SA, Juneja M, Alberti KG (1997) Social inequality in coronary risk: central obesity and the metabolic syndrome. Evidence from the Whitehall II Study. Diabetologia 40:1341–1349
Silventoinen K, Pankow J, Jousilahti P, Hu G, Tuomilehto J (2005) Educational inequalities in the metabolic syndrome and coronary heart disease among middle-aged men and women. Int J Epidemiol 34:327–334
Park SJ, Kang HT, Nam CM, Park BJ, Linton JA, Lee YJ (2012) Sex differences in the relationship between socioeconomic status and metabolic syndrome: the Korean National Health and Nutrition Examination Survey. Diabetes Res Clin Pract 96:400–406
Martínez-Larrad MT, Fernández-Pérez C, González-Sánchez JL, López A, Fernández-Alvarez J, Riviriego J, Serrano-Ríos M, Grupo de Estudio de Atención Primaria de Segovia (2005) Prevalencia del síndrome metabólico (criterios del ATP III). Estudio de base poblacional en áreas rural y urbana de la provincia de Segovia. Med Clin (Barc) 125:481–486
Calbo Mayo JM, Terrancle de Juan I, Fernández Jiménez P, Rodríguez Martín MJ, Martínez Díaz V, Santisteban López Y, Navarro Martínez A, Sáez Méndez L, Gómez Garrido J, Moreno Salcedo J, Vera Hernández J, Fuster Lluch O, Beato JL, Bleda JM, Solera Santos J, Grupo de Estudio Síndrome Metabólico de Albacete (2007) Prevalencia del síndrome metabólico en la provincia de Albacete. Rev Clin Esp 207:64–88
Lim H, Nguyen T, Choue R, Wang Y (2012) Sociodemographic disparities in the composition of metabolic syndrome components among adults in South Korea. Diabetes Care 35:2028–2035
Márquez-Sandoval F, Macedo-Ojeda G, Viramontes-Hörner D, Fernández Ballart JD, Salas Salvadó J, Vizmanos B (2011) The prevalence of metabolic syndrome in Latin America: a systematic review. Public Health Nutr 14:1702–1713
Kastorini CM, Milionis HJ, Esposito K, Giugliano D, Goudevenos JA, Panagiotakos DB (2011) The effect of Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individuals. J Am Coll Cardiol 57:1299–1313
Alexander CM, Landsman PB, Grundy SM (2008) The influence of age and body mass index on the metabolic syndrome and its components. Diabetes Obes Metab 10:246–250
Nutrición y estrategia NAOS. http://www.naos.aesan.msssi.gob.es/. Accessed 2nd Sept 2012
Miettola J, Niskanen LK, Viinamäki H, Sintonen H, Kumpusalo E (2008) Metabolic syndrome is associated with impaired health-related quality of life: Lapinlahti 2005 study. Qual Life Res 17:1055–1062
Schlotz W, Ambery P, Syddall HE, Crozier SR, Sayer AA, Cooper C, Phillips DI, Hertfordshire Cohort Study Group (2007) Specific associations of insulin resistance with impaired health-related quality of life in the Hertfordshire Cohort Study. Qual Life Res 16:429–436
Tziallas D, Kastanioti C, Kostapanos MS, Skapinakis P, Elisaf MS, Mavreas V (2012) The impact of the metabolic syndrome on health-related quality of life: a cross-sectional study in Greece. Eur J Cardiovasc Nurs 11:297–303
Blüher M (2012) Are there still healthy obese patients? Curr Opin Endocrinol Diabetes Obes 19:341–346
Neira M, de Onis M (2006) The Spanish strategy for nutrition, physical activity and the prevention of obesity. Br J Nutr 96(Suppl 1):S8–S11
Acknowledgments
We wish to acknowledge the kind collaboration of the following entities: The Spanish Diabetes Society, the Spanish Diabetes Federation and the Ministry of Health Quality Agency. Our profound appreciation goes to the primary care managers and personnel of the participating Health Centers, as well as to Dr. Luis Forga and Dr. Felipe Casanueva for their inestimable help in the management of the Northern zone. To all the field workers, nurses and dieticians (I. Alonso, A. Arocas, R. Badia, C.M. Bixquert, N. Brito, D. Chaves, A. Cobo, L. Esquius, I Guillén, E. Mañas, A.M. Megido, N. Ojeda, R.M. Suarep, M.D. Zomeño), without whose work the study would not have been possible to carry out and to all the people who voluntarily participated in the study.
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Communicated by Massimo Federici.
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Marcuello, C., Calle-Pascual, A.L., Fuentes, M. et al. Prevalence of the metabolic syndrome in Spain using regional cutoff points for waist circumference: the di@bet.es study. Acta Diabetol 50, 615–623 (2013). https://doi.org/10.1007/s00592-013-0468-8
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DOI: https://doi.org/10.1007/s00592-013-0468-8