Abstract
AimsWe examined, in a country of the African region, i) the prevalence of the metabolic syndrome (MetS) according to three definitions (ATP, WHO and IDF); ii) the distribution of the MetS criteria; iii) the level of agreement between these three definitions and iv) we also examined these issues upon exclusion of people with diabetes.MethodsWe conducted an examination survey on a sample representative of the general population aged 25–64 years in the Seychelles (Indian Ocean, African region), attended by 1255 participants (participation rate of 80.3%).ResultsThe prevalence of MetS increased markedly with age. According to the ATP, WHO and IDF definitions, the prevalence of MetS was, respectively, 24.0%, 25.0%, 25.1% in men and 32.2%, 24.6%, 35.4% in women. Approximately 80% of participants with diabetes also had MetS and the prevalence of MetS was approximately 7% lower upon exclusion of diabetic individuals. High blood pressure and adiposity were the criteria found most frequently among MetS holders irrespective of the MetS definitions. Among people with MetS based on any of the three definitions, 78% met both ATP and IDF criteria, 67% both WHO and IDF criteria, 54% both WHO and ATP criteria and only 37% met all three definitions.ConclusionWe identified a high prevalence of MetS in this population in epidemiological transition. The prevalence of MetS decreased by approximately 32% upon exclusion of persons with diabetes. Because of limited agreement between the MetS definitions, the fairly similar proportions of MetS based on any of the three MetS definitions classified, to a substantial extent, different subjects as having MetS.
Highlights
The metabolic syndrome (MetS) represents a cluster of metabolic risk factors that co-occur to a greater degree than predicted by chance
We identified a high prevalence of MetS in this population in epidemiological transition
The prevalence of MetS decreased by approximately 32% upon exclusion of persons with diabetes
Summary
The metabolic syndrome (MetS) represents a cluster of metabolic risk factors that co-occur to a greater degree than predicted by chance. We consider three major definitions: i) the definition of the World Health Organization (WHO), issued in 1998 [19]; ii) the definition of the National Cholesterol Education Program Adult Treatment Panel III (ATP), issued in 2001 and updated in 2004 and 2005 [20], and the definition of the International Diabetes Federation (IDF), introduced in 2005 [21] These definitions agree that the core criteria of MetS include: i) blood glucose impairment (hyperglycemia and/or insulin resistance), ii) excess abdominal/body fat (increased waist and/or obesity), iii) dyslipidemia (low HDL-cholesterol and/or high triglycerides), and iv) elevated blood pressure. Criteria and cut-off values differ between these definitions, implying that different definitions may identify different people, as documented in the few studies that have addressed this question [4,7,8,22]
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