Abstract
The clustering of central obesity, dyslipidemia, hypertension, and hyperglycemia known as metabolic syndrome has been associated with a two- to three-fold increase in type 2 diabetes (T2DM) and cardiovascular disease (CVD). It is recognized that the features of the metabolic syndrome can be present 10 years preceding T2DM and CVD. The objective of our study was to determine the prevalence of metabolic syndrome in adults aged 25 years and older from an urban population of Karachi, Pakistan, according to the International Diabetes Federation (IDF) definition and modified Adult Treatment Panel III (ATP III) criteria. This study involved a survey conducted from July, 2004, to December, 2004, by generating a computerized random sample of households in Lyari Town using a geographical imaging system (GIS). Out of the 85,520 households, 532 households were randomly selected and 867 adults > or =25 years old consented to take part in the survey; 363 of these subjects gave blood samples. The prevalence of diabetes was 9.4%, whereas 5.6% had impaired fasting glucose (abnormal glucose tolerance 15%). The prevalence of metabolic syndrome according to the IDF definition and modified ATP III criteria was 34.8% and 49%, respectively. Inclusion of modified waist circumference and specific body mass index (BMI) cut offs for Asians may help predict metabolic syndrome at an early stage. High prevalence of metabolic syndrome was identified irrespective of the definition applied in this population. This may call for immediate action to halt the accelerating risk of diabetes and CVD that would lead to a possible unparalleled rise in the cost of health care and human suffering.
Highlights
Title: Prevalence of Metabolic Syndrome in Urban Pakistan (Karachi): Comparison of Newly Proposed International Diabetes Federation and Modified Adult Treatment Panel III Criteria Abstract: The clustering of central obesity, dyslipidemia, hypertension, and hyperglycemia known as metabolic syndrome has been associated with a two- to three-fold increase in type 2 diabetes (T2DM) and cardiovascular disease (CVD)
The objective of our study was to determine the prevalence of metabolic syndrome in adults aged 25 years and older from an urban population of Karachi, Pakistan, according to the International Diabetes Federation (IDF) definition and modified Adult Treatment Panel III (ATP III) criteria
This may call for immediate action to halt the accelerating risk of diabetes and cardiovascular diseases (CVD) that would lead to a possible unparalleled rise in the cost of health care and human suffering
Summary
The modern era has seen the rise of computerization and mechanization, with improved transport resulting in changes in lifestyle from active to sedentary and making an enormous impact on human health. The rise in metabolic syndrome has been partly related to the achievements in public health during the 20th century, with people living longer owing to elimination of many of the communicable diseases.2Over the last 20 years, focus on the metabolic syndrome has gradually increased, and studies have shown that the prevalence of metabolic syndrome is steadily increasing in all populations worldwide, recognizing this as one of the major global public health challenges of recent times. The07-MET-2009_0055.indd 1194/21/2009 6:56:52 PM HYDRIE ET AL.high prevalence of metabolic syndrome and cardiovascular disease (CVD) risk factors have been reported in South Asians. more than one fifth of the world population lives in South Asia, very few studies have been done on metabolic syndrome in this part of the world. During the last two decades, there has been significant changes in society’s life style habits with increase in unhealthy eating, sedentary activities and smoking (Panagiotakos et al, 2003) These habits have fueled the epidemic of obesity, which is an important risk factor for diabetes, cardiovascular diseases, hypertension and dyslipidemia all of which may be preceded by metabolic syndrome (Basit and Shera, 2008). Reliable methods for measuring insulin resistance in vivo such as the hyperinsulinemic euglycemic clamp and minimal-model approximation of the metabolism of glucose (MMAMG) are time-consuming, complicated and require expensive equipment for epidemiological research as well as for clinical practice (6 -8) For this purpose insulin resistance indices have been developed based on fasting blood samples (serum insulin and glucose levels) which are used as reference cutoffs defined for various populations [9].
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