The prevalence and characteristics of metabolic syndrome according to different definitions in China: a nationwide cross-sectional study, 2012–2015
Yilin Huang, Linfeng Zhang, Zengwu Wang, Xin Wang, Zuo Chen, Lan Shao, Ye Tian, Congying Zheng, Lu Chen, Haoqi Zhou, Xue Cao, Yixin Tian, Runlin Gao, for the China Hypertension Survey investigators, Liqun Hu, Hongqi Li, Qi Zhang, Guang Yan, Fangfang Zhu, Xianghua Fang, Chunxiu Wang, Shaochen Guan, Xiaoguang Wu, Hongjun Liu, Chengbei Hou, Han Lei, Wei Huang, Nan Zhang, Li Ge, Lihong Mu, Xiaojun Tang, Ying Han, Huajun Wang, Dongjie Lin, Liangdi Xie, Daixi Lin, Jing Yu, Xiaowei Zhang, Wei Liang, Heng Yu, Qiongying Wang, Lan Yang, Yingqing Feng, Yuqing Huang, Peixi Wang, Jiaji Wang, Haoxiang Wang, Songtao Tang, Tangwei Liu, Rongjie Huang, Zhiyuan Jiang, Haichan Qin, Guoqin Liu, Zhijun Liu, Wenbo Rao, Zhe Chen, Yalin Chu, Fang Wu, Haitao Li, Jianlin Ma, Tao Chen, Ming Wu, Jixin Sun, Yajing Cao, Yuhuan Liu, Zhikun Zhang, Yanmei Liu, Dejin Dong, Guangrong Li, Hong Guo, Lihang Dong, Haiyu Zhang, Fengyu Sun, Xingbo Gu, Kaijuan Wang, Chunhua Song, Peng Wang, Hua Ye, Wei Nie, Shuying Liang, Congxin Huang, Fang Chen, Yan Zhang, Heng Zhou, Jing Xie, Jianfang Liu, Hong Yuan, Chengxian Guo, Yuelong Huang, Biyun Chen, Xingsheng Zhao, Wenshuai He, Wen Xia, Yanan Lu, Xiangqing Kong, Ming Gui, Wenhua Xu, Yan Lü, Jun Huang, Min Pan
Abstract
BACKGROUND: Metabolic syndrome (MetS) is characterized by a cluster of signs of metabolic disturbance and has caused a huge burden on the health system. The study aims to explore the prevalence and characteristics of MetS defined by different criteria in the Chinese population. METHODS: Using the data of the China Hypertension Survey (CHS), a nationally representative cross-sectional study from October 2012 to December 2015, a total of 28,717 participants aged 35 years and above were included in the analysis. The MetS definitions of the International Diabetes Federation (IDF), the updated US National Cholesterol Education Program Adult Treatment Panel III (the revised ATP III), and the Joint Committee for Developing Chinese Guidelines (JCDCG) on Prevention and Treatment of Dyslipidemia in Adults were used. Multivariable logistic regression was used to identify factors associated with MetS. RESULTS: The prevalence of MetS diagnosed according to the definitions of IDF, the revised ATP III, and JCCDS was 26.4%, 32.3%, and 21.5%, respectively. The MetS prevalence in men was lower than in women by IDF definition (22.2% vs. 30.3%) and by the revised ATP III definition (29.2% vs. 35.4%), but the opposite was true by JCDCG (24.4%vs 18.5%) definition. The consistency between the three definitions for men and the revised ATP III definition and IDF definition for women was relatively good, with kappa values ranging from 0.77 to 0.89, but the consistency between the JCDCG definition and IDF definition (kappa = 0.58) and revised ATP III definition (kappa = 0.58) was poor. Multivariable logistic regression showed that although the impact and correlation intensity varied with gender and definition, area, age, education, smoking, alcohol use, and family history of cardiovascular disease were factors related to MetS. CONCLUSIONS: The prevalence and characteristics of the MetS vary with the definition used in the Chinese population. The three MetS definitions are more consistent in men but relatively poor in women. On the other hand, even if estimated according to the definition of the lowest prevalence, MetS is common in China.