Abstract
BackgroundMetabolic syndrome (MetS), a major contributor to cardiovascular disease and diabetes, is considered to be among the most common public health problems worldwide.ObjectiveWe aimed to identify and rank the most important nutritional and nonnutritional factors contributing to the development of MetS using a data-mining method.MethodsThis prospective study was performed on 3048 adults (aged ≥20 years) who participated in the fifth follow-up examination of the Tehran Lipid and Glucose Study, who were followed for 3 years. MetS was defined according to the modified definition of the National Cholesterol Education Program/Adult Treatment Panel III. The importance of variables was obtained by the training set using the random forest model for determining factors with the greatest contribution to developing MetS.ResultsAmong the 3048 participants, 701 (22.9%) developed MetS during the study period. The mean age of the participants was 44.3 years (SD 11.8). The total incidence rate of MetS was 229.9 (95% CI 278.6-322.9) per 1000 person-years and the mean follow-up time was 40.5 months (SD 7.3). The incidence of MetS was significantly (P<.001) higher in men than in women (27% vs 20%). Those affected by MetS were older, married, had diabetes, with lower levels of education, and had a higher BMI (P<.001). The percentage of hospitalized patients was higher among those with MetS than among healthy people, although this difference was only statistically significant in women (P=.02). Based on the variable importance and multiple logistic regression analyses, the most important determinants of MetS were identified as history of diabetes (odds ratio [OR] 6.3, 95% CI 3.9-10.2, P<.001), BMI (OR 1.2, 95% CI 1.0-1.2, P<.001), age (OR 1.0, 95% CI 1.0-1.03, P<.001), female gender (OR 0.5, 95% CI 0.38-0.63, P<.001), and dietary monounsaturated fatty acid (OR 0.97, 95% CI 0.94-0.99, P=.04).ConclusionsBased on our findings, the incidence rate of MetS was significantly higher in men than in women in Tehran. The most important determinants of MetS were history of diabetes, high BMI, older age, male gender, and low dietary monounsaturated fatty acid intake.
Highlights
Metabolic syndrome (MetS), a major contributor to cardiovascular disease and diabetes, is considered to be among the most common public health problems worldwide [1]
Based on our findings, the incidence rate of MetS was significantly higher in men than in women in Tehran
In Iran, the overall pooled prevalence and incidence rate of MetS among the general population was reported to be 0.26 and 97.96 per 1000 person-years, respectively, and was higher in women living in urban areas and in men living in rural areas
Summary
Metabolic syndrome (MetS), a major contributor to cardiovascular disease and diabetes, is considered to be among the most common public health problems worldwide [1]. In Iran, the overall pooled prevalence and incidence rate of MetS among the general population was reported to be 0.26 (95% CI 0.25-0.29) and 97.96 per 1000 person-years (95% CI 75.98-131.48), respectively, and was higher in women living in urban areas and in men living in rural areas. Considering the high prevalence of MetS and its importance in cardiovascular disease, identifying and ranking the most important nutritional and nonnutritional factors in the occurrence of MetS is an essential analysis with respect to public health. We aimed to identify and rank the most important nutritional and nonnutritional factors in the occurrence of MetS among the general population of Tehran, Iran, using the RF data-mining method. Metabolic syndrome (MetS), a major contributor to cardiovascular disease and diabetes, is considered to be among the most common public health problems worldwide
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