A nationwide study of metabolic syndrome prevalence in Iran; a comparative analysis of six definitions

Ozra Tabatabaei-Malazy; Sahar Saeedi Moghaddam; Nazila Rezaei; Ali Sheidaei; Mohammad Javad Hajipour; Negar Mahmoudi; Zohreh Mahmoudi; Arezou Dilmaghani-Marand; Kamyar Rezaee; Mahdi Sabooni; Farideh Razi; Farzad Kompani; Alireza Delavari; Bagher Larijani; Farshad Farzadfar

doi:10.1371/journal.pone.0241926

A nationwide study of metabolic syndrome prevalence in Iran; a comparative analysis of six definitions

PLoS One. 2021 Mar 3;16(3):e0241926. doi: 10.1371/journal.pone.0241926. eCollection 2021.

Authors

Ozra Tabatabaei-Malazy^{1

2}, Sahar Saeedi Moghaddam¹, Nazila Rezaei¹, Ali Sheidaei^{1

3}, Mohammad Javad Hajipour^{1

4}, Negar Mahmoudi¹, Zohreh Mahmoudi¹, Arezou Dilmaghani-Marand¹, Kamyar Rezaee¹, Mahdi Sabooni^{1

5}, Farideh Razi⁶, Farzad Kompani⁷, Alireza Delavari⁸, Bagher Larijani², Farshad Farzadfar^{1

2}

Affiliations

¹ Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
² Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
³ Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
⁴ Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
⁵ Reference Health Laboratory, Ministry of Health and Medical Education, Tehran, Iran.
⁶ Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁷ Division of Hematology and Oncology, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
⁸ Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: To integrate and execute a proper preventive plan and reduce the risk of non-communicable diseases (NCDs), policy makers need to have access to both reliable data and a unique definition of metabolic syndrome (MetS). This study was conducted on the data collected by cross-sectional studies of WHO's STEPwise approach to surveillance of NCD risk factors (STEPs) to estimate the national and sub-national prevalence rates of MetS in Iran in 2016.

Materials and methods: The prevalence of MetS was estimated among 18,414 individuals aged ≥25 years living in urban and rural areas of Iran using various definition criteria; National Cholesterol Education Program Adult Treatment Panel III 2004 (ATP III), International Diabetes Federation (IDF), American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI), Joint Interim Statement (JIS). Regional IDF (RIDF) and JIS (RJIS) were defined using ethnicity-specific values of waist circumference for the country.

Results: National prevalence rate of MetS based on ATP III, IDF, AHA/NHLBI, JIS, RIDF and RJIS criteria were 38.3% (95% CI 37.4-39.1), 43.5% (42.7-44.4), 40.9% (40.1-41.8), 47.6% (46.8-48.5), 32.0% (31.2-32.9), and 40.8% (40.0-41.7), respectively. The prevalence was higher among females, in urban residents, and those aged 65-69 years. MetS was expected to affect about 18.7, 21.3, 20.0, 23.3, 15.7, and 20.0 million Iranians, respectively, based on ATP III, IDF, AHA/NHLBI, JIS, RIDF and RJIS. The two most common components noted in this population were reduced high-density lipoprotein cholesterol (HDL-C) levels and central obesity.

Conclusion: High prevalence rate of MetS among Iranian adults is alarming, especially among females, urban residents, and the elderly. The JIS definition criteria is more appropriate to determine higher number of Iranians at risk of NCDs. Proper management and prevention of MetS is required to adopt multiple national plans including lifestyle modifications, medical interventions, and public education on NCDs risk factors.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Cross-Sectional Studies
Female
Humans
Iran / epidemiology
Male
Metabolic Syndrome / epidemiology*
Middle Aged
Prevalence
Risk Factors

Grants and funding

This study was supported by Iran Ministry of Health and Medical Education (http://ird.behdasht.gov.ir/) and National Institute of Health Research (http://nihr.tums.ac.ir/En). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.