Rural‐urban and gender differences in the prevalence of metabolic syndrome among older Indians

Abstract

AbstractBackgroundThe clinical significance of metabolic syndrome (MetS) as a risk factor for cardiovascular disease, cerebrovascular disease, and dementia is becoming increasingly prominent. However, there is a dearth of studies from India on the prevalence of MetS, especially in the aging population. We aimed to estimate MetS prevalence and associated comorbidities in two prospective, aging cohorts from rural and urban India.MethodOur study sample includes aging (≥ 45 years) individuals – 2171 from the rural (SANSCOG) cohort and 332 from the urban (TLSA) cohort. These older Indian adults have contrasting population characteristics, which echo the stark rural‐urban divide in the country. Data from baseline clinical and biochemical assessments were used to calculate the prevalence of MetS in both the above cohorts using two well‐established criteria, namely consensus criteria and NCEP‐ATP III criteria. Further, we compare rural‐urban, gender‐ and age‐wise differences in the prevalence of MetS as per the consensus criteria.ResultPrevalence of MetS was 46.2% and 54.8% as per consensus criteria in rural and urban subjects, respectively; corresponding numbers using NCEP‐ATP III criteria were 40.3% and 45.1%. Rural‐dwelling older adults had a significantly lesser prevalence of all individual MetS parameters except impaired triglycerides and high‐density lipoprotein levels. Rural women had a significantly higher prevalence than rural men, whereas there was no significant difference among urban subjects. We did not observe any consistent age‐wise trend when comparing both these cohorts. There was a high burden of comorbidities among both groups, mostly undiagnosed in rural subjects.ConclusionRoughly 1 in 2 older Indians have MetS, urban significantly more than rural, reaching an alarming 63.1% among urban subjects aged 65‐74 years. The very high prevalence of undiagnosed co‐morbidities in rural Indians is extremely concerning, calling for urgent public health measures including ramping up the primary health care system in this marginalized and health disparate population.