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Gender difference on the development of metabolic syndrome: a population-based study in Taiwan

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Abstract

Little is known regarding the development of metabolic syndrome. This study examining gender difference in the characteristics of metabolic components aimed to estimate the development of metabolic syndrome in both genders. This nation-wide, population-based survey included 5,880 men and women aged 20–79 years in Taiwan. Metabolic syndrome was defined by the revised National Cholesterol Education Program Adult Treatment Panel III, with adoption of the Asian criteria for abdominal obesity. The results indicate that metabolic syndrome was prevalent in 20.4% of the men and 15.3% of the women. Lipid components occurred the earliest in both genders. The appearance of the first isolated component was earlier in women than in men (mean age 43.4 vs. 45.6 years, P < 0.05). In contrast, the mean prevalent age of metabolic syndrome appeared earlier in men than in women by 4.9 years (mean age 51.3 vs. 56.2 years, P < 0.05). The differences in prevalent age from the appearance of any isolated component to metabolic syndrome were 12.8 years in women and 5.7 years in men, respectively. If men had a body mass index less than 23 kg/m2 and exercise habits, the difference in the prevalent age from the isolated component to metabolic syndrome was 15.4 years, longer than for all women subjects. We conclude lipid components appeared the earliest. Women had the first isolated component earlier, presenting as metabolic syndrome later than men. The development of metabolic syndrome was slower in subjects without overweight characteristics and with exercise habits.

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Abbreviations

BMI:

Body mass index

BP:

Blood pressure

FPG:

Fasting plasma glucose

HDL:

High-density lipoprotein cholesterol

METS:

Metabolic syndrome

NCEP ATP III:

National cholesterol education program expert panel adult treatment panel III

TG:

Triglyceride

WC:

Waist circumference

References

  1. Executive summary of the third report of the national cholesterol education program (NCEP) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 2001;285:2486–97.

    Google Scholar 

  2. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Disagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific statement. Circulation 2005;112:2735–52.

    Article  PubMed  Google Scholar 

  3. Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002;288:2709–16.

    Article  PubMed  Google Scholar 

  4. Wilson WF, D’Agostino RB, Parise H, Sullivan L, Meigs JB. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation 2005; 112:3066–72.

    Article  PubMed  CAS  Google Scholar 

  5. Jackson R, Chambless L, Higgins M, Kuulasmaa K, Wijnberg L, Williams D. WHO MONICA Project, and ARIC Study Sex difference in ischaemic heart disease mortality and risk factors in 46 communities: an ecologic analysis. Cardiovasc Risk Factors 1997;7:43–54.

    Google Scholar 

  6. Jousilahti P, Vartiainen E, Tuomilehto J, Puska P. Sex, age, cardiovascular risk factors, and coronary heart disease: a prospective follow-up study of 14,786 middle aged men and women in Finland. Circulation 1999;99:1165–72.

    PubMed  CAS  Google Scholar 

  7. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults findings from the Third National Health and Nutrition Examination Survey. JAMA 2002;287:356–9.

    Article  PubMed  Google Scholar 

  8. Ang LW, Ma S, Cutter J, Chew SK, Tan CE, Tai ES. The metabolic syndrome in Chinese, Malays and Asian Indians. Factor analysis of data from the 1998 Singapore National Health Survey. Diabetes Res Clin Pract 2005;67:53–62.

    PubMed  CAS  Google Scholar 

  9. Tan CE, Ma S, Wai D, Chew SK, Tai ES. Can we apply the National Cholesterol Education Program Adult Treatment Panel definition of the metabolic syndrome to Asians? Diabetes Care 2004;27:1182–6.

    Article  PubMed  Google Scholar 

  10. Oh JY, Hong YS, Sung YA, Barrett-Connor E. Prevalence and factor analysis of metabolic syndrome in an urban Korean population. Diabetes Care 2004;27:2027–32.

    Article  PubMed  Google Scholar 

  11. Chuang SY, Chen CH, Chou P. Prevalence of metabolic syndrome in a large health check-up population in Taiwan. J Chin Med Assoc 2004;67:611–20.

    PubMed  Google Scholar 

  12. Park HS, Oh SW, Cho SI, Choi WH, Kim YS. The metabolic syndrome and associated lifestyle factors among South Korean adults. Int J Epidemiol 2004;33:328–36.

    Article  PubMed  Google Scholar 

  13. Cameron AJ, Shaw JE, Zimmet PZ. The metabolic syndrome: prevalence in worldwide populations. Endocrinol Metab Clin North Am 2004;33:351–75.

    Article  PubMed  Google Scholar 

  14. Carr MC. The emergence of the metabolic syndrome with menopause. J Clin Endocrinol Metab 2003;88:2404–11.

    Article  PubMed  CAS  Google Scholar 

  15. Berenson GS, Srinivasan SR, Bao W, Newman WP, Tracy RE, et al. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. N Engl J Med 1998;338:1650–6.

    Article  PubMed  CAS  Google Scholar 

  16. Orchard TJ, Temprosa M, Goldberg R, Haffner S, Ratner R, Marcovina S, et al. The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program Randomized Trial. Ann Intern Med 2005;142:611–9.

    PubMed  CAS  Google Scholar 

  17. Hwang LC, Bai CH, Chen CJ. Prevalence of obesity and metabolic syndrome in Taiwan. J Formos Med Assoc 2006;105:626–35.

    Article  PubMed  Google Scholar 

  18. World Health Organization. The Asia-Pacific perspective: redefining obesity and its treatment. WHO: Geneva; 2000.

  19. Academic Technology Services in University of California, Los Angeles. Resources to help you learn and use of SUDAAN. Available at: http://www.ats.ulca.edu/stat/sudaan/faq/svy_howtochoose.htm. Accessed January 30, 2006.

  20. Shen YH, Yang WS, Lee TH, Lee LT, Chen CY, Huang KC. Bright liver and alanine aminotranferase and associated with metabolic syndrome in adults. Obes Res 2005;13:1238–45.

    Article  PubMed  CAS  Google Scholar 

  21. Miller WC, Lindeman AK, Wallace J, Niederpruem M. Diet composition, energy intake, and exercise in relation to body fat in men and women. Am J Clin Nutr 1990;52:426–30.

    PubMed  CAS  Google Scholar 

  22. Mahoney LT, Burns TL, W Stanford W, Thompson BH, Witt JD, Rost CA, et al. Coronary risk factors measured in childhood and young adult life are associated with coronary artery calcification in young adults: the Muscatine Study. J Am Coll Cardiol 1996;27:277–84.

    Article  PubMed  CAS  Google Scholar 

  23. Hoff JA, Chomka EV, Krainik AJ, Daviglus M, Rich S, Kondos GT. Age and gender distribution of coronary artery calcium detected by electron beam tomography in 35,246 adults. Am J Cardiol 2001;87:1335–9.

    Article  PubMed  CAS  Google Scholar 

  24. Mittendorfer B. Insulin resistance: sex matters. Curr Opin Clin Nutr Metab Care 2005;8:367–72.

    Article  PubMed  CAS  Google Scholar 

  25. Murphy MJ, Metcalf BS, Voss LD, et al. Girls at five are intrinsically more insulin resistant than boys: the programming hypotheses revisited—The EarlyBird Study (EarlyBird 6). Pediatrics 2004;113:82–6.

    Article  PubMed  Google Scholar 

  26. Nuutila P, Knuuti MJ, Maki M, et al. Gender and insulin sensitivity in the heart and in skeletal muscles. Studies using positron emission tomography. Diabetes 1995;44:31–6.

    Article  PubMed  CAS  Google Scholar 

  27. Nishizawa H, Shimomura I, Kishida K, et al. Androgens decrease plasma adiponectin, an insulin-sensitizing adipocyte-derived protein. Diabetes 2002;51:2734–41.

    Article  PubMed  CAS  Google Scholar 

  28. Wajchenberg BL. Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. Endocr Rev 2000;21:697–738.

    Article  PubMed  CAS  Google Scholar 

  29. Jehn M, Clark JM, Guallar G. Serum ferritin and risk of the metabolic syndrome in US adults. Diabetes Care 2004;27:2422–8.

    Article  PubMed  Google Scholar 

  30. Punnonen R, Ikalainen M, Seppala E. Premenopausal hysterectomy and risk of cardiovascular disease. Lancet 1987;1:1139.

    Article  PubMed  CAS  Google Scholar 

  31. Lin WY, Lee LT, Chen CY, et al. Optimal cut-off values for obesity: using simple anthropometric indices to predict cardiovascular risk factors in Taiwan. Int J Obes Relat Metab Disord 2002;26:1232–8.

    Article  PubMed  Google Scholar 

  32. Ouyang P, Sung J, Kelemen MD, Hees PS, DeRegis JR, Turner KL, et al. Relationships of insulin sensitivity with fatness and fitness in older men and women. J Women’s Health 2004;13:177–85.

    Article  Google Scholar 

  33. Boulé NG, Weisnagel SJ, Lakka TA, Tremblay A, Bergman RN, Rankinen T, et al. Effects of exercise training on glucose homeostasis: the HERITAGE Family Study. Diabetes Care 2005;28:108–14.

    Article  PubMed  Google Scholar 

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Acknowledgements

We would like to thank all investigators of TwSHHH Project for their contribution to the compilation and validation the data. This study was supported by the Bureau of Health Promotion in Taiwan.

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Authors and Affiliations

  1. Department of Family Medicine, Mackay Memorial Hospital, Taipei, Taiwan, ROC

    Lee-Ching Hwang

  2. Department of Nursing, Mackay Medicine, Nursing and Management College, Taipei, Taiwan, ROC

    Lee-Ching Hwang

  3. Central Laboratory, Shin Kong WHS Memorial Hospital, Taipei, Taiwan, ROC

    Chyi-Huey Bai

  4. Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, No. 1 Jen-Ai Road Section 1, Taipei, 10018, Taiwan, ROC

    Chien-Jen Chen

  5. Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC

    Kuo-Liong Chien

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  1. Lee-Ching Hwang
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  2. Chyi-Huey Bai
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  4. Kuo-Liong Chien
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Correspondence to Chien-Jen Chen.

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Hwang, LC., Bai, CH., Chen, CJ. et al. Gender difference on the development of metabolic syndrome: a population-based study in Taiwan. Eur J Epidemiol 22, 899–906 (2007). https://doi.org/10.1007/s10654-007-9183-5

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  • DOI: https://doi.org/10.1007/s10654-007-9183-5

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