Advertisement

Metabolic Syndrome and Social Deprivation

  • Marie Blanquet
  • Anne Debost-Legrand
  • Laurent Gerbaud
Living reference work entry

Abstract

The metabolic syndrome is a set of disorders responsible for an increased risk of all-cause and cardiovascular mortality. Social deprivation is defined as the lack of [one or more of the prerequisites of] security, enabling persons to assume their responsibilities into the society and to enjoy basic rights. A review of the literature published over the past 16 years (2000–2016) was performed to analyze the association between metabolic syndrome and social deprivation. Of the 652 references reviewed for title and abstract, 78 studies were selected and 55 articles were considered. The absence of uniformity in the measures used to assess metabolic syndrome and social deprivation requires some modulation of the results of our analysis. The studies were classified according to the Human Development Index (HDI) of the countries where they took place. The principal risk factors identified for metabolic syndrome are a low educational level (women especially), low income, occupation (specifically an unskilled job or absence from the labor force), and greater socioeconomic deprivation, measured by composite indices. These results are stable according to HDI level.

In conclusion, access to education, the possibility of superior education, and the acquisition of occupational credentials are three themes to prioritize in developing public health policies, irrespective of the country’s level of development.

Keywords

Metabolic syndrome Social deprivation Geographic indices Individual deprivation 

List of Abbreviations

AHA

American Heart Association

HDI

Human Development Index

IDF

International Diabetes Foundation

NCEP-ATPIII

National Cholesterol Education Program Adult Treatment Panel III

WHO

World Health Organization

References

  1. Adedoyin RA, Afolabi A, Adegoke OO, Akintomide AO, Awotidebe TO (2013) Relationship between socioeconomic status and metabolic syndrome among nigerian adults. Diabetes Metab Syndr 7(2):91–94.  https://doi.org/10.1016/j.dsx.2013.02.014CrossRefPubMedGoogle Scholar
  2. Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15(7):539–553.  https://doi.org/10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-SCrossRefPubMedGoogle Scholar
  3. Alberti K, George MM, Zimmet P, Shaw J (2005) The metabolic syndrome – a new worldwide definition. Lancet 366(9491):1059–1062.  https://doi.org/10.1016/S0140-6736(05)67402-8CrossRefPubMedGoogle Scholar
  4. Alberti G, Zimmet P, Shaw J, Grundy SM (2006) The IDF consensus worldwide definition of the metabolic syndrome. In: International Diabetes Federation. Diabet Med 23(5):469–80Google Scholar
  5. Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart J-C et al (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(16): 1640–1645.  https://doi.org/10.1161/CIRCULATIONAHA.109.192644CrossRefPubMedGoogle Scholar
  6. Al-Daghri NM, Alkharfy KM, Al-Attas OS, Khan N, Alfawaz HA, Alghanim SA, Al-Yousef MA, Al-Ajlan ASM, Alokail MS (2014) Gender-dependent associations between socioeconomic status and metabolic syndrome: a cross-sectional Study in the Adult Saudi Population. BMC Cardiovasc Disord 14(avril):51.  https://doi.org/10.1186/1471-2261-14-51CrossRefPubMedPubMedCentralGoogle Scholar
  7. Belfki H, Ali SB, Aounallah-Skhiri H, Traissac P, Bougatef S, Maire B, Delpeuch F, Achour N, Romdhane HB (2013) Prevalence and determinants of the metabolic syndrome among Tunisian adults: results of the Transition and Health Impact in North Africa (TAHINA) project. Public Health Nutr 16(4):582–590.  https://doi.org/10.1017/S1368980012003291CrossRefPubMedGoogle Scholar
  8. Binh TQ, Phuong PT, Nhung BT, Tung DD (2014) Metabolic syndrome among a middle-aged population in the Red River Delta Region of Vietnam. BMC Endocr Disord 14(septembre):77.  https://doi.org/10.1186/1472-6823-14-77CrossRefPubMedPubMedCentralGoogle Scholar
  9. Blanquet M, Debost-Legrand A, Gerbaud L, de La Celle C, Brigand A, Mioche L, Sass C, Hazart J, Aw A (2016) Metabolic syndrome and social deprivation: results of a French Observational Multicentre Survey. Fam Pract 33(1):17–22.  https://doi.org/10.1093/fampra/cmv086CrossRefPubMedGoogle Scholar
  10. Carnethon MR, Loria CM, Hill JO, Sidney S, Savage PJ, Liu K, Coronary Artery Risk Development in Young Adults study (2004) Risk factors for the metabolic syndrome: the Coronary Artery Risk Development in Young Adults (CARDIA) Study, 1985–2001. Diabetes Care 27(11):2707–2715CrossRefPubMedGoogle Scholar
  11. Carstairs V, Morris R (1989) Deprivation: explaining differences in mortality between Scotland and England and Wales. Br Med J 299(6704):886–889CrossRefGoogle Scholar
  12. Chichlowska KL, Rose KM, Diez-Roux AV, Golden SH, McNeill AM, Heiss G (2008) Individual and neighborhood socioeconomic status characteristics and prevalence of metabolic syndrome: the Atherosclerosis Risk in Communities (ARIC) Study. Psychosom Med 70(9):986–992.  https://doi.org/10.1097/PSY.0b013e318183a491CrossRefPubMedPubMedCentralGoogle Scholar
  13. da Silveira VMF, Horta BL, Gigante DP, Junior MRA (2010) Metabolic syndrome in the 1982 Pelotas Cohort: effect of contemporary lifestyle and socioeconomic status. Arq Bras Endocrinol Metabol 54(4):390–397CrossRefPubMedGoogle Scholar
  14. Dallongeville J, Cottel D, Ferrières J, Arveiler D, Bingham A, Ruidavets JB, Haas B, Ducimetière P, Amouyel P (2005) Household income is associated with the risk of metabolic syndrome in a sex-specific manner. Diabetes Care 28(2):409–415CrossRefPubMedGoogle Scholar
  15. Ebrahimi H, Emamian MH, Shariati M, Hashemi H, Fotouhi A (2016) Metabolic syndrome and its risk factors among middle aged population of Iran, a Population Based Study. Diabetes Metab Syndr 10(1):19–22.  https://doi.org/10.1016/j.dsx.2015.08.009CrossRefPubMedGoogle Scholar
  16. Eckel RH, Grundy SM, Zimmet PZ (2005) The metabolic syndrome. Lancet (London) 365(9468): 1415–1428.  https://doi.org/10.1016/S0140-6736(05)66378-7CrossRefGoogle Scholar
  17. Eckel RH, Alberti KGMM, Grundy SM, Zimmet PZ (2010) The metabolic syndrome. Lancet (London) 375(9710):181–183.  https://doi.org/10.1016/S0140-6736(09)61794-3CrossRefGoogle Scholar
  18. Enkh-Oyun T, Kotani K, Davaalkham D, Davaa G, Ganchimeg U, Angarmurun D, Khuderchuluun N et al (2015) Epidemiologic features of metabolic syndrome in a general mongolian population. Metab Syndr Relat Disord 13(4):179–186.  https://doi.org/10.1089/met.2014.0067CrossRefPubMedGoogle Scholar
  19. Erem C, Hacihasanoglu A, Deger O, Topbaş M, Hosver I, Ersoz HO, Can G (2008) Prevalence of metabolic syndrome and associated risk factors among Turkish Adults: Trabzon MetS Study. Endocrine 33(1):9–20.  https://doi.org/10.1007/s12020-008-9044-3CrossRefPubMedGoogle Scholar
  20. Ferguson TS, Younger N, Tulloch-Reid MK, Forrester TE, Cooper RS, Van den Broeck J, Wilks RJ (2010) Prevalence of the Metabolic Syndrome in Jamaican Adults and Its Relationship to Income and Education Levels. West Indian Med J 59(3):265–273PubMedGoogle Scholar
  21. Gannar F, de León AC, Díaz BB, Pérez MDCR, Rodríguez IM, Dahmen FB, Sakly M, Attia N (2015) Social class and metabolic syndrome in populations from Tunisia and Spain. Diabetol Metab Syndr 7:88.  https://doi.org/10.1186/s13098-015-0084-6CrossRefPubMedPubMedCentralGoogle Scholar
  22. Gronner MF, Bosi PL, Carvalho AM, Casale G, Contrera D, Pereira MA, Diogo TM et al (2011) Prevalence of metabolic syndrome and its association with educational inequalities among Brazilian Adults: a population-based study. Braz J Med Biol Res 44(7):713–719CrossRefPubMedGoogle Scholar
  23. Grundy SM, Bryan Brewer H, Cleeman JI, Smith SC, Lenfant C, American Heart Association, National Heart, Lung, and Blood Institute (2004) Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 109(3):433–438.  https://doi.org/10.1161/01.CIR.0000111245.75752.C6CrossRefPubMedGoogle Scholar
  24. 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(10):1066–1076.  https://doi.org/10.1001/archinte.164.10.1066CrossRefPubMedGoogle Scholar
  25. Isomaa B, Almgren P, Tuomi T, Forsén B, Lahti K, Nissén M, Taskinen MR, Groop L (2001) Cardiovascular morbidity and mortality associated with the metabolic Syndrome. Diabetes Care 24(4):683–689CrossRefPubMedGoogle Scholar
  26. Kaduka LU, Kombe Y, Kenya E, Kuria E, Bore JK, Bukania ZN, Mwangi M (2012) Prevalence of metabolic syndrome among an Urban Population in Kenya. Diabetes Care 35(4):887–893.  https://doi.org/10.2337/dc11-0537CrossRefPubMedPubMedCentralGoogle Scholar
  27. Keita AD, Judd SE, Howard VJ, Carson AP, Ard JD, Fernandez JR (2014) Associations of neighborhood area level deprivation with the metabolic syndrome and inflammation among middle- and older-age adults. BMC Public Health 14(décembre):1319.  https://doi.org/10.1186/1471-2458-14-1319CrossRefPubMedPubMedCentralGoogle Scholar
  28. Khanam MA, Qiu C, Lindeboom W, Streatfield PK, Kabir ZN, Wahlin Å (2011) The metabolic syndrome: prevalence, associated factors, and impact on survival among older persons in Rural Bangladesh. PLoS One 6(6):e20259.  https://doi.org/10.1371/journal.pone.0020259CrossRefPubMedPubMedCentralGoogle Scholar
  29. Klijs B, Angelini V, Mierau JO, Smidt N (2016) The role of life-course socioeconomic and lifestyle factors in the intergenerational transmission of the metabolic syndrome: results from the LifeLines Cohort Study. Int J Epidemiol 45(4):1236–1246.  https://doi.org/10.1093/ije/dyw076PubMedGoogle Scholar
  30. La Rosa E, Le Clésiau H, Valensi P (2008) Metabolic syndrome and psychosocial deprivation. Data collected from a Paris Suburb. Diabete Metab 34(2):155–161.  https://doi.org/10.1016/j.diabet.2007.12.005CrossRefPubMedGoogle Scholar
  31. Labbe E, Blanquet M, Gerbaud L, Poirier G, Sass C, Vendittelli F, Moulin J-J (2015) A new reliable index to measure individual deprivation: the EPICES score. Eur J Pub Health 25(4):604–609.  https://doi.org/10.1093/eurpub/cku231CrossRefGoogle Scholar
  32. Lakka H-M, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT (2002) The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 288(21):2709–2716CrossRefPubMedGoogle Scholar
  33. Langenberg C, Kuh D, Wadsworth MEJ, Brunner E, Hardy R (2006) Social circumstances and education: life course origins of social inequalities in metabolic risk in a Prospective National Birth Cohort. Am J Public Health 96(12):2216–2221.  https://doi.org/10.2105/AJPH.2004.049429CrossRefPubMedPubMedCentralGoogle Scholar
  34. Lao XQ, Ma WJ, Sobko T, Zhang YH, Xu YJ, Xu XJ, Yu DM et al (2014) Dramatic escalation in metabolic syndrome and cardiovascular risk in a Chinese Population Experiencing Rapid Economic Development. BMC Public Health 14(septembre):983.  https://doi.org/10.1186/1471-2458-14-983CrossRefPubMedPubMedCentralGoogle Scholar
  35. Lidfeldt J, Nyberg P, Nerbrand C, Samsioe G, Scherstén B, Agardh CD (2003) Socio-demographic and psychosocial factors are associated with features of the metabolic syndrome. The Women’s Health in the Lund Area (WHILA) study. Diabetes Obes Metab 5(2):106–112CrossRefPubMedGoogle Scholar
  36. Lim W, So W-Y (2015) Lifestyle-related factors and their association with metabolic syndrome in Korean Adults: a population-based study. J Phys Ther Sci 27(3):555–558.  https://doi.org/10.1589/jpts.27.555CrossRefPubMedPubMedCentralGoogle Scholar
  37. Loucks EB, Rehkopf DH, Thurston RC, Kawachi I (2007) Socioeconomic disparities in metabolic syndrome differ by gender: evidence from NHANES III. Ann Epidemiol 17(1): 19–26.  https://doi.org/10.1016/j.annepidem.2006.07.002CrossRefPubMedGoogle Scholar
  38. Lucove JC, Kaufman JS, James SA (2007) Association between adult and childhood socioeconomic status and prevalence of the metabolic syndrome in African Americans: the Pitt County Study. Am J Public Health 97(2):234–236.  https://doi.org/10.2105/AJPH.2006.087429CrossRefPubMedPubMedCentralGoogle Scholar
  39. Manuck SB, Phillips JE, Gianaros PJ, Flory JD, Muldoon MF (2010) Subjective socioeconomic status and presence of the metabolic syndrome in midlife community volunteers. Psychosom Med 72(1):35–45.  https://doi.org/10.1097/PSY.0b013e3181c484dcCrossRefPubMedGoogle Scholar
  40. Marquezine GF, Oliveira CM, Pereira AC, Krieger JE, Mill JG (2008) Metabolic syndrome determinants in an Urban population from Brazil: social class and gender-specific interaction. Int J Cardiol 129(2):259–265.  https://doi.org/10.1016/j.ijcard.2007.07.097CrossRefPubMedGoogle Scholar
  41. Martin A, Neale EP, Batterham M, Tapsell LC (2016) Identifying metabolic syndrome in a clinical cohort: implications for prevention of chronic disease. Prev Med Rep 4(décembre):502–506.  https://doi.org/10.1016/j.pmedr.2016.09.007CrossRefPubMedPubMedCentralGoogle Scholar
  42. Navarro M d C, Saavedra P, Jódar E, Jesús Gómez de Tejada M, Mirallave A, Sosa M (2013) Osteoporosis and metabolic syndrome according to socio-economic status, contribution of PTH, vitamin D and body weight: the Canarian Osteoporosis Poverty Study (COPS). Clin Endocrinol 78(5):681–686.  https://doi.org/10.1111/cen.12051CrossRefGoogle Scholar
  43. Ni L-F, Dai Y-T, Su T-C, Hu W-Y (2013) Substance use, gender, socioeconomic status and metabolic syndrome among adults in Taiwan. Public Health Nurs (Boston) 30(1):18–28.  https://doi.org/10.1111/j.1525-1446.2012.01039.xCrossRefGoogle Scholar
  44. Ortiz MS, Myers HF, Schetter CD, Rodriguez CJ, Seeman TE (2015) Psychosocial predictors of metabolic syndrome among Latino groups in the Multi-Ethnic Study of Atherosclerosis (MESA). PLoS One 10(4):e0124517.  https://doi.org/10.1371/journal.pone.0124517CrossRefPubMedPubMedCentralGoogle Scholar
  45. Pampalon R, Raymond G (2000) A deprivation index for health and welfare planning in Quebec. Chronic Dis Can 21(3):104–113PubMedGoogle Scholar
  46. Park Y-W, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB (2003) The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med 163(4): 427–436CrossRefPubMedPubMedCentralGoogle Scholar
  47. Park MJ, Yun KE, Go EL, Cho HJ, Park HS (2007) A cross-sectional study of socioeconomic status and the metabolic syndrome in Korean adults. Ann Epidemiol 17(4):320–326.  https://doi.org/10.1016/j.annepidem.2006.10.007CrossRefPubMedGoogle Scholar
  48. Perel P, Langenberg C, Ferrie J, Moser K, Brunner E, Marmot M (2006) Household Wealth and the metabolic syndrome in the Whitehall II Study. Diabetes Care 29(12):2694–2700.  https://doi.org/10.2337/dc06-0022CrossRefPubMedGoogle Scholar
  49. Phillips AC, Douglas C, Neil Thomas G, Gale CR, Deary I, David Batty G (2010) The influence of multiple indices of socioeconomic disadvantage across the adult life course on the metabolic syndrome: the Vietnam Experience Study. Metab Clin Exp 59(8):1164–1171.  https://doi.org/10.1016/j.metabol.2009.11.009CrossRefPubMedGoogle Scholar
  50. Podang J, Sritara P, Narksawat K (2013) Prevalence and factors associated with metabolic syndrome among a Group of Thai Working Population: A Cross Sectional Study. J Med Assoc Thail 96(Suppl 5 (décembre)):S33–S41Google Scholar
  51. Prescott E, Godtfredsen N, Osler M, Schnohr P, Barefoot J (2007) Social gradient in the metabolic syndrome not explained by psychosocial and behavioural factors: evidence from the Copenhagen City Heart Study. Eur J Cardiovasc Prev Rehabil 14(3):405–412.  https://doi.org/10.1097/HJR.0b013e32800ff169CrossRefPubMedGoogle Scholar
  52. Programme des Nations Unies pour le Développement (2015) Rapport sur le développement humain. PNUD. http://hdr.undp.org/sites/default/files/2015_human_development_report_overview_-_fr.pdf
  53. Ramsay SE, Whincup PH, Morris R, Lennon L, Wannamethee SG (2008) Is socioeconomic position related to the prevalence of metabolic syndrome?: Influence of social class across the life course in a Population-Based Study of Older Men. Diabetes Care 31(12):2380–2382.  https://doi.org/10.2337/dc08-1158CrossRefPubMedPubMedCentralGoogle Scholar
  54. Riediger ND, Clara I (2011) Prevalence of metabolic syndrome in the Canadian Adult Population. Can Med Assoc J 183(15):E1127–E1134.  https://doi.org/10.1503/cmaj.110070CrossRefGoogle Scholar
  55. Romaguera J, Ortiz AP, Roca FJ, Colón G, Suárez E (2010) Factors associated with metabolic syndrome in a sample of women in Puerto Rico. Menopause (New York) 17(2): 388–392.  https://doi.org/10.1097/gme.0b013e3181bd5393CrossRefGoogle Scholar
  56. Salsberry PJ, Corwin E, Reagan PB (2007) A complex web of risks for metabolic syndrome: race/ethnicity, economics, and gender. Am J Prev Med 33(2):114–120.  https://doi.org/10.1016/j.amepre.2007.03.017CrossRefPubMedGoogle Scholar
  57. Santos AC, Ebrahim S, Barros H (2008) Gender, socio-economic status and metabolic syndrome in middle-aged and old adults. BMC Public Health 18(8):62.  https://doi.org/10.1186/1471-2458-8-62
  58. Schooling CM, Jiang CQ, Lam TH, Zhang WS, Cheng KK, Leung GM (2008) Life-course origins of social inequalities in metabolic risk in the population of a developing country. Am J Epidemiol 167(4):419–428.  https://doi.org/10.1093/aje/kwm329CrossRefPubMedGoogle Scholar
  59. Scuteri A, Vuga M, Najjar SS, Mehta V, Everson-Rose SA, Sutton-Tyrrell K, Matthews K, Lakatta EG (2008) Education eclipses ethnicity in predicting the development of the metabolic syndrome in different ethnic groups in Midlife: The Study of Women’s Health Across the Nation (SWAN). Diabet Med 25(12):1390–1399.  https://doi.org/10.1111/j.1464-5491.2008.02596.xCrossRefPubMedPubMedCentralGoogle Scholar
  60. Sen A (1999) Commodities and capabilities. Oxford University Press, OxfordGoogle Scholar
  61. Sidorenkov O, Nilssen O, Grjibovski AM (2010) Metabolic syndrome in Russian adults: associated factors and mortality from cardiovascular diseases and all causes. BMC Public Health 10(septembre):582.  https://doi.org/10.1186/1471-2458-10-582CrossRefPubMedPubMedCentralGoogle Scholar
  62. Son LNTD, Kunii D, Hung NTK, Sakai T, Yamamoto S (2005) The metabolic syndrome: prevalence and risk factors in the Urban population of Ho Chi Minh City. Diabetes Res Clin Pract 67(3):243–250.  https://doi.org/10.1016/j.diabres.2004.07.014CrossRefGoogle Scholar
  63. Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, Brand H, (HLS-EU) Consortium Health Literacy Project European (2012) Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health 12(janvier):80.  https://doi.org/10.1186/1471-2458-12-80CrossRefPubMedPubMedCentralGoogle Scholar
  64. Soysal A, Şimşek H, Doğanay S, Günay T (2016) Prevalence of metabolic syndrome and affecting factors among individuals aged 30 and over in Balçova District of İzmir. Balkan Med J 33(3):331–338.  https://doi.org/10.5152/balkanmedj.2016.141033CrossRefPubMedPubMedCentralGoogle Scholar
  65. Sygnowska E, Piwońska A, Waśkiewicz A, Broda G (2012) Socioeconomic factors and the risk of metabolic syndrome in the adult polish population: the WOBASZ Study. Kardiol Pol 70(7): 718–727PubMedGoogle Scholar
  66. Tan AKG, Dunn RA, Yen ST (2011) Ethnic disparities in metabolic syndrome in Malaysia: an analysis by risk factors. Metab Syndr Relat Disord 9(6):441–451.  https://doi.org/10.1089/met.2011.0031CrossRefPubMedPubMedCentralGoogle Scholar
  67. Townsend P (1987) Deprivation. J Soc Policy 16(02):125–146.  https://doi.org/10.1017/S0047279400020341CrossRefGoogle Scholar
  68. Villamor E, Finan CC, Ramirez-Zea M, Roman AV, Nine Mesoamerican Countries Metabolic Syndrome Study (NiMeCoMeS) Group (2016) Prevalence and sociodemographic correlates of metabolic syndrome in school-aged children and their parents in nine mesoamerican countries. Public Health Nutr 20(septembre):1–11.  https://doi.org/10.1017/S1368980016002342Google Scholar
  69. Wrezinski J (1987) Grande pauvreté et précarité économique et sociale. Avis et rapports du conseil économique et social 6. Journal Officiel de la République Française. Conseil Economique et SocialGoogle Scholar
  70. Yang JJ, Yoon H-S, Lee S-A, Choi J-Y, Song M, Han S, Lee J-K, Kang D (2014) Metabolic syndrome and sex-specific socio-economic disparities in childhood and adulthood: the Korea National Health and Nutrition Examination Surveys. Diabet Med 31(11):1399–1409.  https://doi.org/10.1111/dme.12525CrossRefPubMedGoogle Scholar
  71. Zhan Y, Yu J, Chen R, Gao J, Ding R, Fu Y, Zhang L, Hu D (2012) Socioeconomic status and metabolic syndrome in the general population of China: a Cross-Sectional Study. BMC Public Health 12(octobre):921.  https://doi.org/10.1186/1471-2458-12-921CrossRefPubMedPubMedCentralGoogle Scholar
  72. Zhao Y, Yan H, Yang R, Li Q, Dang S, Wang Y (2014) Prevalence and determinants of metabolic syndrome among adults in a rural area of Northwest China. PLoS One 9(3):e91578.  https://doi.org/10.1371/journal.pone.0091578CrossRefPubMedPubMedCentralGoogle Scholar
  73. Zuo H, Shi Z, Hu X, Wu M, Guo Z, Hussain A (2009) Prevalence of metabolic syndrome and factors associated with its components in Chinese adults. Metab Clin Exp 58(8):1102–1108.  https://doi.org/10.1016/j.metabol.2009.04.008CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Marie Blanquet
    • 1
    • 2
  • Anne Debost-Legrand
    • 3
    • 2
  • Laurent Gerbaud
    • 1
    • 2
  1. 1.Service de Santé PubliqueCentre Hospitalier Universitaire de Clermont-FerrandClermont-Ferrand Cedex 1France
  2. 2.Université Clermont Auvergne, CNRS-UMR 6602Institut Pascal, Axe TGI, Groupe PEPRADEClermont-FerrandFrance
  3. 3.Pôle Femme Et EnfantCentre Hospitalier Universitaire de Clermont-FerrandClermont-FerrandFrance

Personalised recommendations