Metabolic syndrome in central Brazil: prevalence and correlates in the adult population

Diabetology & Metabolic Syndrome

Marina Kiyomi Ito³  Edgar Merchán- Hamann⁴  Édina Miyazaki²  Kênia MaraBaiocchi de Carvalho¹  Eliane Said Dutra³ 

[1] Programa de Pós-graduação em Nutrição Humana, Faculdade de Ciências da Saúde, Universidade de Brasília, Brasília, DF, 70910-900, Brazil;Departamento de Estatística, Universidade de Brasília, Brasília, DF, 70910-900, Brazil;Programa de Pós-graduação em Ciências da Saúde, Faculdade de Ciências da Saúde, Universidade de Brasília, Campus Darcy Ribeiro, Brasília, DF, 70910-900, Brazil;Departamento de Saúde Coletiva, Faculdade de Ciências da Saúde, Universidade de Brasília, Brasília, DF, 70910-900, Brazil

关键词: Brazil;    Education;    Developing country;    Prevalence;    Metabolic syndrome;   

Others  :  815065
DOI  :  10.1186/1758-5996-4-20

 received in 2011-10-14, accepted in 2012-03-13,  发布年份 2012

【 摘 要 】

Background

The prevalence of metabolic syndrome (MetS) has increased in developing countries in recent decades. This syndrome, a clustering of metabolic abnormalities, has been correlated to various socioeconomic and behavioral variables. We investigated the prevalence and prevalence ratios (PR) of MetS and related factors in an adult population of the Federal District (FD) of Brazil, which is located in the central region of the country.

Methods

A cross-sectional, population-based study conducted in 2007, with 2130 adults (aged 18 years or older) in the FD of Brazil. Metabolic syndrome was defined according to the recently harmonized criteria. The prevalence of MetS and PR were estimated for each sex according to the diagnostic components and the overall contribution of the selected correlates.

Results

The overall prevalence of MetS was 32.0% (95%CI: 28.9–35.2), with no gender difference. The single component with the greatest contribution to the diagnosis of MetS was hypertension in men (PR 5.10, 95%CI: 3.17–8.22) and high waist circumference in women (PR 5.02, 95%CI: 3.77–6.69). The prevalence of MetS increased significantly and progressively with age and excess weight. In women, higher education was protective against MetS (PR 0.66, 95%CI: 0.49–0.89) compared to 8 or less years of education. There was no association between the prevalence of MetS and behavioral variables studied.

Conclusions

This study provides comprehensive and alarming data about the prevalence of MetS among the adult population of Brazil’s FD. The results suggest that reducing education inequalities may be an important public policy goal to improve health outcomes, especially among women.

【 授权许可】

   
2012 Dutra et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Gaziano TA, Bitton A, Anand S, Abrahams-Gessel S, Murphy A: Growing epidemic of coronary heart disease in low- and middle-income countries. Curr Probl Cardiol 2010, 35:72-115.
• [2]Gersh BJ, Sliwa K, Mayosi BM, Yusuf S: Novel therapeutic concepts: the epidemic of cardiovascular disease in the developing world: global implications. Eur Heart J 2010, 31:642-648.
• [3]Alberti K, Eckel R, Grundy S, Zimmet P, Cleeman J, Donato K, Fruchart J, James W, Loria C, Smith S: Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009, 120:1640-1645.
• [4]Ford ES, Li C, Sattar N: Metabolic syndrome and incident diabetes: current state of the evidence. Diabetes Care 2008, 31:1898-1904.
• [5]Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, Montori VM: Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 2007, 49:403-414.
• [6]Wilson PW, D’Agostino RB, Parise H, Sullivan L, Meigs JB: Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation 2005, 112:3066-3072.
• [7]Bayturan O, Tuzcu EM, Lavoie A, Hu T, Wolski K, Schoenhagen P, Kapadia S, Nissen SE, Nicholls SJ: The metabolic syndrome, its component risk factors, and progression of coronary atherosclerosis. Arch Intern Med 2010, 170:478-484.
• [8]Mente A, Yusuf S, Islam S, McQueen MJ, Tanomsup S, Onen CL, Rangarajan S, Gerstein HC, Anand SS: Metabolic syndrome and risk of acute myocardial infarction a case–control study of 26,903 subjects from 52 countries. J Am Coll Cardiol 2010, 55:2390-2398.
• [9]Simmons RK, Alberti KG, Gale EA, Colagiuri S, Tuomilehto J, Qiao Q, Ramachandran A, Tajima N, Brajkovich Mirchov I, Ben-Nakhi A, Reaven G, Hama Sambo B, Mendis S, Roglic G: The metabolic syndrome: useful concept or clinical tool? Report of a WHO Expert Consultation. Diabetologia 2010, 53:600-605.
• [10]Cameron A: The metabolic syndrome: validity and utility of clinical definitions for cardiovascular disease and diabetes risk prediction. Maturitas 2010, 65:117-121.
• [11]Misra A, Khurana L: Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab 2008, 93(Suppl 1):9-30.
• [12]Batsis JA, Nieto-Martinez RE, Lopez-Jimenez F: Metabolic syndrome: from global epidemiology to individualized medicine. Clin Pharmacol Ther 2007, 82:509-524.
• [13]Cornier MA, Dabelea D, Hernandez TL, Lindstrom RC, Steig AJ, Stob NR, Van Pelt RE, Wang H, Eckel RH: The metabolic syndrome. Endocr Rev 2008, 29:777-822.
• [14]Executive Panel on Detection Evaluation and Treatment of High Blood Cholesterol in Adults: Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 2001, 285:2486-2497.
• [15]Escobedo J, Schargrodsky H, Champagne B, Silva H, Boissonnet CP, Vinueza R, Torres M, Hernandez R, Wilson E: Prevalence of the metabolic syndrome in Latin America and its association with sub-clinical carotid atherosclerosis: the CARMELA cross sectional study. Cardiovasc Diabetol 2009, 26:52-60.
• [16]Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, Singh GM, Gutierrez HR, Lu Y, Bahalim AN, Farzadfar F, Riley LM, Ezzati M: National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9· 1 million participants. Lancet 2011, 377:557-567.
• [17]Schmidt MI, Duncan BB, Azevedo e Silva G, Menezes AM, Monteiro CA, Barreto SM, Chor D, Menezes PR: Chronic non-communicable diseases in Brazil: burden and current challenges. Lancet 2011, 377:1949-1961.
• [18]Barbosa PJ, Lessa I, de Almeida Filho N, Magalhães LB, Araújo J: Criteria for central obesity in a Brazilian population: impact on metabolic syndrome. Arq Bras Cardiol 2006, 87:407-414.
• [19]Marquezine GF, Oliveira CM, Pereira AC, Krieger JE, Mill JG: Metabolic syndrome determinants in an urban population from Brazil: social class and gender-specific interaction. Int J Cardiol 2008, 129:259-265.
• [20]Silventoinen K, Pankow J, Jousilahti P, Hu G, Tuomilehto J: Educational inequalities in the metabolic syndrome and coronary heart disease among middle-aged men and women. Int J Epidemiol 2005, 34:327-334.
• [21]Loucks EB, Rehkopf DH, Thurston RC, Kawachi I: Socioeconomic disparities in metabolic syndrome differ by gender: evidence from NHANES III. Ann Epidemiol 2007, 17:19-26.
• [22]: Demographic Census 2000 – Brazil. [http://www.ibge.gov.br/english/estatistica/populacao/censo2000/ webcite]
• [23]Friedewald WT, Levy RI, Fredrickson DS: Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972, 18:499-502.
• [24]Pena SDJ, Di Pietro G, Fuchshuber-Moraes M, Genro JP, Hutz MH, Kehdy FSG, Kohlrausch F, Magno LAV, Montenegro RC, Moraes MO, Moraes MEA, Moraes MR, Ojopi EB, Perini JA, Racciopi Cl, Ribeiro-dos-Santos AKC, Rios-Santos F, Romano-Silva MA, Sortica VA, Suarez-Kurtz G: The genomic ancestry of individuals from different geographical regions of Brazil is more uniform than expected. PLoS ONE 2011, 6:e17063.
• [25]Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P: International physical activity questionnaire: 12- country reliability and validity. Med Sci Sports Exerc 2003, 35:1381-1395.
• [26]Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A: Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007, 39:1423-1434.
• [27]Barros AJ, Hirakata VN: Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol 2003, 3:21. BioMed Central Full Text
• [28]Monteiro CA, Conde WL, Popkin BM: Income-specific trends in obesity in Brazil: 1975–2003. Am J Public Health 2007, 97:1808-1812.
• [29]Moura EC, Claro RM: Estimates of obesity trends in Brazil, 2006–2009. Int J Public Healthin press
• [30]Ervin RB: Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States, 2003–2006. Natl Health Stat Report 2009, 13:1-7.
• [31]Florez H, Silva E, Fernández V, Ryder E, Sulbarán T, Campos G, Calmón G, Clavel E, Castillo-Florez S, Goldberg R: Prevalence and risk factors associated with the metabolic syndrome and dyslipidemia in White, Black, Amerindian and Mixed Hispanics in Zulia State, Venezuela. Diabetes Res Clin Pract 2005, 69:63-77.
• [32]Gelaye B, Revilla L, Lopez T, Sanchez S, Williams MA: Prevalence of metabolic syndrome and its relationship with leisure time physical activity among Peruvian adults. Eur J Clin Invest 2009, 39:891-898.
• [33]Ramachandran A, Snehalatha C, Satyavani K, Sivasankari S, Vijay V: Metabolic syndrome in urban Asian Indian adults–a population study using modified ATP III criteria. Diabetes Res Clin Pract 2003, 60:199-204.
• [34]Amuna P, Zotor FB: Epidemiological and nutrition transition in developing countries: impact on human health and development. Proc Nutr Soc 2008, 67:82-90.
• [35]Chow CK, Lock K, Teo K, Subramanian SV, McKee M, Yusuf S: Environmental and societal influences acting on cardiovascular risk factors and disease at a population level: a review. Int J Epidemiol 2009, 38:1580-1594.
• [36]Salsberry PJ, Corwin E, Reagan PB: A complex web of risks for metabolic syndrome: race/ethnicity, economics, and gender. Am J Prev Med 2007, 33:114-120.
• [37]Dekker JM, Girman C, Rhodes T, Nijpels G, Stehouwer CD, Bouter LM, Heine RJ: Metabolic syndrome and 10-year cardiovascular disease risk in the Hoorn Study. Circulation 2005, 112:666-673.
• [38]McNeill AM, Rosamond WD, Girman CJ, Golden SH, Schmidt MI, East HE, Ballantyne CM, Heiss G: The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study. Diabetes Care 2005, 28:385-390.
• [39]Knuiman MW, Hung J, Divitini ML, Davis TM, Beilby JP: Utility of the metabolic syndrome and its components in the prediction of incident cardiovascular disease: a prospective cohort study. Eur J Cardiovasc Prev Rehabil 2009, 16:235-241.
• [40]World Health Organization: Global health risks: mortality and burden of disease attributable to selected major risks. , Geneva; 2009.
• [41]Santos AC, Severo M, Barros H: Incidence and risk factors for the metabolic syndrome in an urban South European population. Prev Med 2010, 50:99-105.
• [42]Despre’s JP, Lemieux I: Abdominal obesity and metabolic syndrome. Nature 2006, 444:881-887.
• [43]Khunti K, Taub N, Tringham J, Jarvis J, Farooqi A, Skinner TC, Davies MJ: Screening for the metabolic syndrome using simple anthropometric measurements in south Asian and white Europeans: a population-based screening study. The Leicester Ethnic Atherosclerosis and Diabetes Risk (LEADER) Study. Prim Care Diabetes 2010, 4:25-32.
• [44]Alberti K, Zimmet P, Shaw J: The metabolic syndrome–a new worldwide definition. Lancet 2005, 366:1059-1062.
• [45]Cuevas A, Alvarez V, Carrasco F: Epidemic of metabolic syndrome in Latin America. Curr Opin Endocrinol Diabetes Obes 2011, 18:134-138.
• [46]Alves-Silva J, da Silva Santos M, Guimarães PE, Ferreira AC, Bandelt HJ, Pena SD, Prado VF: The ancestry of Brazilian mtDNA lineages. Am J Hum Genet 2000, 67:444-461.
• [47]Kim MH, Kim MK, Choi BY, Shin YJ: Educational disparities in the metabolic syndrome in a rapidly changing society–the case of South Korea. Int J Epidemiol 2005, 34:1266-1273.
• [48]Beltrão KI, Alves JED: A reversão do hiato de gênero na educação brasileira no século XX. Cad Pesqui 2009, 39:125-156.
• [49]Chichlowska KL, Rose KM, Diez-Roux AV, Golden SH, McNeill AM, Heiss G: Life course socioeconomic conditions and metabolic syndrome in adults: the Atherosclerosis Risk in Communities (ARIC) Study. Ann Epidemiol 2009, 19:875-883.