Prevalence of the metabolic syndrome in rural India—a disparity in definitions

Abstract

Although the metabolic syndrome is a known predictor of coronary heart disease and type-2 diabetes mellitus, it has no agreed definition. The concordance of its various definitions has been studied for a limited number of populations and there are few studies on the rural populations in India. The present study was done to determine the prevalence of metabolic syndrome in a rural population of South India and to evaluate the concordance of the modified National Cholesterol Education Programme-Adult Treatment Panel III definition and International Diabetes Federation definition for the diagnosis of Metabolic Syndrome. Anthropometric and biochemical parameters (fasting blood glucose and lipid profile) and blood pressure were measured using standard procedures. The prevalence of metabolic syndrome was calculated using the two sets of criteria and compared for their concordance. Descriptive statistics was used to analyze age and risk factors of metabolic syndrome. The chi-square test was applied to compare the prevalence of metabolic syndrome obtained from the two criteria (significant if p < 0.05). An inter-rater reliability analysis using the kappa statistic was performed to determine consistency between the two sets of criteria in diagnosing the metabolic syndrome. The modified National Cholesterol Education Programme-Adult Treatment Panel III definition and International Diabetes Federation definition for metabolic syndrome identified overall age-adjusted prevalence of 17.8% and 20.5% respectively, which were not significantly different. Kappa statistics revealed only moderate agreement of 0.44 between the two sets of criteria. The impact of economic development and preponderance of genetic factors is increasing the prevalence of metabolic syndrome in rural India. It is important to determine which definition of the metabolic syndrome best predicts coronary heart disease and type 2 diabetes in this population in order to formulate effective public health policy.