Abstract
Metabolic syndrome (MetS) increases the risk of cardiovascular diseases and diabetes mellitus. This study is designed to assess the prevalence and determinants of MetS among Nepalese adults from a nationally representative study. This study is based on Stepwise Approach to Surveillance (STEPS) Survey from Nepal. This survey was done among 4200 adults aged 15–69 years from 210 clusters selected proportionately across Nepal’s three ecological zones (Mountain, Hill and Terai). Subsequently, using systematic sampling, twenty households per cluster and one participant per household were selected. The overall prevalence of MetS is 15% and 16% according to Adult Treatment Panel III (ATP III) and International Diabetes Federation (IDF) criteria respectively. A triad of low HDL-C, abdominal obesity and high BP was the most prevalent (8.18%), followed by abdominal obesity, low HDL-C cholesterol and high triglycerides (8%). Less than two percent of participants had all the five components of the syndrome and 19% of participants had none. The prevalence steadily rose across the age group with adults aged 45–69 years having the highest prevalence (28–30%) and comparable prevalence across two definitions of MetS. A notably high burden for females, urban, hill or Terai resident were seen among other factors.
Highlights
The inter-related cluster of cardio-metabolic risk factors comprising of elevated fasting glucose, elevated blood pressure, elevated triglycerides (TG), reduced high-density lipoprotein (HDL) and central obesity has been termed Metabolic syndrome (MetS) in the literature[1]
The prevalence of metabolic syndrome is 15% and 16% according to Adult Treatment Panel III (ATP III) and International Diabetes Federation (IDF) criteria respectively
A significantly high prevalence of abdominal obesity and low HDL cholesterol was observed among female participants; whereas raised triglycerides, fasting blood sugar and high blood pressure was observed among male participants (Table 1)
Summary
The inter-related cluster of cardio-metabolic risk factors comprising of elevated fasting glucose, elevated blood pressure, elevated triglycerides (TG), reduced high-density lipoprotein (HDL) and central obesity has been termed Metabolic syndrome (MetS) in the literature[1]. A recent hospital based study conducted in a random sample of indoor patients from tertiary levels hospitals found that 31% of admitted patients suffer from NCDs; with cardiovascular disease and diabetes accounting for 40% and 12% of NCDs respectively[10]. This hospital based study might not reflect the true prevalence of NCDs at population level in Nepal as utilization of www.nature.com/scientificreports/. A focus on individual components of MetS is a norm in routine practice, as well as the recently formed Multi-sectoral Action Plan of NCDs from Ministry of Health of Nepal addresses hypertension, diabetes, obesity and raised cholesterol separately while MetS is unaddressed giving the lack of evidence at population level. This is important for local planning, addressing the population burden via concerted actions on its determinants and targeting the high-risk groups
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