PREVALENCE AND RISK FACTORS OF METABOLIC SYNDROME AMONG ADULTS IN A NORTHEASTERN PROVINCE OF THAILAND
Keywords:
Metabolic syndrome, prevalence, risk factors, access to health care, adult, ThailandAbstract
This cross-sectional study aimed to determine the prevalence of metabolic syndrome (MetS), and its associated risk factors among adults aged ≥35 years in a northeastern province of Thailand. The study was conducted with 829 adults recruited from rural and urban areas of Amnat Charoen Province, Thailand. MetS was defined according to “revised ATP III criteria”. Data were collected by face-to-face interview, anthropometric assessment and blood examination. About 27.5% of the participants had MetS. Twenty-four new cases with high TG were detected. Among MetS components, abdominal obesity had the highest prevalence (61.1%), followed by high triglycerides (45.6%) and low high-density lipoprotein cholesterol (36.1%). All participants had health insurance. Logistic regression analyses revealed that the significant predictors of MetS were: being older (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01 to 1.05), being female (OR, 1.50; 95%CI, 1.04 to 2.24), having a family history of hypertension (OR, 2.07; 95%CI, 1.41 to 3.04), and having a high BMI (OR, 2.03; 95%CI, 1.73 to 2.04). In conclusion, the prevalence of MetS among the participants was moderately high. Health personnel should conduct periodic surveys to monitor for MetS and arrange tailored lifestyle modification interventions to improve intake of healthy and high-quality food, and increase physical activity. These interventions should be an integral part of the clinical management of MetS.
References
Aekplakorn, W., Chongsuvivatwong, V., Tatsanavivat, P., and Suriyawongpaisal, P. (2011a). Prevalence of metabolic syndrome defined by the international diabetes federation and national cholesterol education program criteria among Thai adults. Asia-Pac. J. Public. Health., 23(5):792-800.
Aekplakorn, W., Kessomboon, P., Sangthong, R., Chariyalertsak, S., Putwatana, P., Inthawong, R., Nitiyanant, W., Taneepanichskul, S., and NHES IV study group. (2011b). Urban and rural variation in clustering of metabolic syndrome components in the Thai population: Results from the fourth National Health Examination Survey 2009. BMC. Public Health., 11:854.
Alberti, K.G.M.M., Eckel, R.H., Grundy, S.M., Zimmet, P.Z., Cleeman, J.I., Donato, K.A., Fruchart, J.C., James, W.P., Loria, C.M., and Smith, S.C.Jr. (2009). 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., 120(16):1640-1645.
Alberti, K.G., and Zimmet PZ. (1998). Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet. Med., 15(7):539-553.
Alberti, K.G.M.M., Zimmet, P., and Shaw, J. (2005). The metabolic syndrome – A new worldwide definition. Lancet., 366(9491):1059-1062.
Amnat Charoen Provincial Statistical Office. (2016a). Available from: http://amnatchr.nso.go.th/index. php?option=com_content&view=article&id=341:2560&catid=105&Itemid=510 (Thai). Accessed date: Dec 23, 2016.
Amnat Charoen Provincial Health Office, Thailand. (2016b). Annual Health Report 2015. Amnat Charoen: Amnat Charoen Provincial Health Office, p. 5-16 (in Thai).
Boonyapiphat, P., and Noparat, C. (2018). Laboratory procedure manual. Department of Pathology, Faculty of Medicine, Prince of Songkla University. Available from: http://www.pathology.psu.ac.th/ images/PathoDoc/PathoManual2561.pdf 156p. (Thai). Accessed date: Jan 5, 2018.
Branchi, A., Fiorenza. A.M., Torri, A., Muzio, F., Berra, C., Colombo, E., Dalla Valle, E., Rovellini, A., and Sommariva, D. (2001). Effects of low doses of simvastatin and atorvastatin on high-density lipoprotein cholesterol levels in patients with hypercholesterolemia. Clin Ther., 23(6):851-7.
Burke, V., Beilin, L.J., Simmer, K., Oddy, W.H., Blake, K.V., Doherty, D., Kendall, G.E., Newnham, J.P., Landau, L,I, and Stanley FJ. (2005). Predictors of body mass index and associations with cardiovascular risk factors in Australian children: a prospective cohort study. Int. J. Obes. (Lond)., 29(1):15-23.
Cheong, K.C., Ghazali, S.M., Hock, L.K., Subenthiran, S., Huey, T.C., Kuay, L.K., Mustapha, F.I., Yusoff, A.F., and Mustafa, A.N. (2015). The discriminative ability of waist circumference, body mass index and waist-to-hip ratio in identifying metabolic syndrome: Variations by age, sex and race. Diabetes Metab. Syndr., 9(2): 74-78.
Daniel, W.W., and Cross, C.L. (2013). Biostatistics: a foundation for analysis in the health sciences. 10th ed. Wiley: Singapore, 960p.
Eckel, R.H., Alberti, K.G.M.M., Grundy, S.M., and Zimmet, PZ. (2010). The metabolic syndrome. Lancet., 375(9710):181-183.
Health Insurance System Research Office (HISRO). (2012). Thailand’s Universal Coverage Scheme: Achievements and Challenges. An independent assessment of the first 10 years (2001-2010) Synthesis Report. Nonthaburi, Thailand: HISRO, 120p. Available from: http://www.jointlearningnetwork. org/uploads/files/resources/book018.pdf Accessed date: Oct 1, 2017
IHME. (2017). Measuring what matters. Available from: http://www.healthdata.org/thailand Accessed date: Oct 15, 2017.
Isomaa, B., Almgren, P., Tuomi, T., Forsén, B., Lahti, K., Nissén, M., Taskinen, M.R., and Groop, L. (2001). Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care., 24(4):683-689.
Kusinitz, I., and Fine, M. (2016). Your Guide to Getting Fit. 3rd ed. Mountain View, Calif.: Mayfield; 1995. Available from: http://www.mhhe.com/socscience/ hhp/wellness/060.htm Accessed date: Oct 20. 2016.
Lim, E.S., Ko, Y.K., and Ban, K.O. (2013). Prevalence and risk factors of metabolic syndrome in the Korean population - Korean National Health Insurance Corporation Survey 2008. J. Adv. Nurs., 69(7):1549-1561.
Macpherson, M., de Groh, M., Loukine, L., Prud’homme, D., and Dubois, L. (2016). Prevalence of metabolic syndrome and its risk factors in Canadian children and adolescents: Canadian health measures survey cycle 1 (2007-2009) and cycle 2 (2009-2011). Health Promot Chronic Dis. Prev. Can., 36(2):32-40.
Mendrick, D.L., Diehl, A.M., Topor, L.S., Dietert, R.R., Will, Y., La, Merrill, M.A., Bouret, S., Varma, V., Hastings, K.L., Schug, T.T., Emeigh, Hart, S.G., and Burleson, F.G. (2018). Metabolic Syndrome and Associated Diseases: From the Bench to the Clinic. Toxicol Sci., 162(1):36-42.
Ministry of Health, Manatu Hauora. (2017). Definitions of smoking status. Available from: https://www. health.govt.nz/our-work/preventative517health-wellness/tobacco-control/tobacco-control-information 518practitioners/definitions-smoking-status Accessed date: Jan 6, 2017.
Moon, J.H., Roh, E., Oh, T.J., Kim, K.M., Moon, J.H., Lim, S., Jang, H.C., and Choi, S.H. (2017). Increased risk of metabolic disorders in healthy young adults with family history of diabetes: from the Korea National Health and Nutrition Survey. Diabetol. Metab. Syndr., 9:16.
National Institute on Alcohol Abuse and Alcoholism. (2017). Drinking levels defined. Available from: https://www.niaaa.nih.gov/alcohol525health/ overview-alcohol-consumption/moderate-binge-drinking Accessed date: Jan 6, 2017.
NCEP. (2002). 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) final report. Circulation., 106(25):3,143-3,421.
O'Neill, S. and O'Driscoll, L. (2015). Metabolic syndrome: A closer look at the growing epidemic and its associated pathologies. Obes. Rev., 16(1):1-12.
Paek, S.C., Meemon, N., and Wan, T.T. (2016). Thailand's universal coverage scheme and its impact on health-seeking behavior. Springerplus., 5(1):1952.
Penchansky, R., and Thomas, J.W. (1981). The concept of access: definition and relationship to consumer satisfaction. Med. Care., 19(2):127-140.
Pickering, T.G., Hall, J.E., Appel, L.J., Falkner, B.E., Graves, J.W., Hill, M.N., Jones, D.H., Kurtz, T., Sheps, S.G., Roccella, E.J., Council on High Blood Pressure Research Professional and Public Education Subcommittee, and American Heart Association. (2005). Recommendations for blood pressure measurement in humans: an AHA scientific statement from the Council on High Blood Pressure Research Professional and Public Education Subcommittee. J. Clin. Hypertens. (Greenwich)., 7(2):102-109.
Ranasinghe, P., Cooray, D.N., Jayawardena, R., and Katulanda, P. (2015a). The influence of family history of Hypertension on disease prevalence and associated metabolic risk factors among Sri Lankan adults. BMC. Public. Health., 15: 576.
Ranasinghe, P., Mathangasinghe, Y., Jayawardena, R., Hills, A.P., and Misra A. (2017b). Prevalence and trends of metabolic syndrome among adults in the Asia-Pacific region: A systematic review. BMC. Public. Health., 17(1):101.
Rostron, B. (2012). Alcohol consumption and mortality risks in the USA. Alcohol. Alcohol., 47(3):334-339.
Siewert, S., Filipuzzi, S., Codazzi, L., Gonzalez, I., and Ojeda, M.S. (2007). Impact of metabolic syndrome risk factors in first-degree relatives of type 2 diabetic patients. Rev. Diabet. Stud., 4(3):177-184.
Solini, A., Santini, E., Passaro, A., Madec, S., and Ferrannini, E. (2009). Family history of hypertension, anthropometric parameters and markers of early atherosclerosis in young healthy individuals. J. Hum. Hypertens., 23(12):801–817.
Steffes, M. (2016). Laboratory procedure manual. Available from: https://www.cdc.gov/nchs/data/nhanes/ nhanes_07_08/glu_e_met_fasting _glucose_ModP. pdf. Accessed date: Nov 25, 2016.
Tangcharoensathien, V., Limwattananon, S., Patcharanarumol, W., and Thammatachareem J. (2014). Monitoring and evaluating progress towards Universal Health Coverage in Thailand. PLoS. Med., 11(9): e1001726.
Tyrovolas, S., Chalkias, C., Morena, M., Tsiligianni, I., Zeimbekis, A., Zeimbekis, A., Gotsis, E., Metallinos, G., Bountziouka, V., Polychronopoulos, E., Lionis, C., and Panagiotakos D. (2011). Health care access and prevalence of the metabolic syndrome among elders living in high-altitude areas of the Mediterranean islands: The MEDIS study. Rev. Diabetic. Stud., 8(4):468-476.
Veghari, G., Sedaghat, M., Maghsodlo, S., Banihashem, S., Moharloei, P., Angizeh, A., Tazik, E., Moghaddami, A., and Joshaghani H. (2015). The association between abdominal obesity and serum cholesterol level. Int. J. Appl. Basic. Med. Res., 5(2):83-86.
Wikipedia, the free encyclopedia. (2016). Amnat Charoen province. Available from: https://en.wikipedia.org/ wiki/Amnat_Charoen_Province Accessed date: Dec 20, 2016.
Xiao, J., Wu, C.L., Gao, Y.X., Wang, S.L., Wang, L., Lu, Q.Y., Wang, X.J., Hua, T.Q., Shen, H., and Cai, H. (2016). Prevalence of metabolic syndrome and its risk factors among rural adults in Nantong, China. Sci. Rep., 6:38089.
Yang, F. (2017). Prevalence of the metabolic syndrome in the middle-aged and older Chinese population. Int. J. Diabetes. Dev. Countries., 37(2):176-182.
Yu, S., Guo, X., Yang, H., Zheng, L., and Sun, Y. (2014). An update on the prevalence of metabolic syndrome and its associated factors in rural northeast China. BMC. Public Health., 26;14(1):877.
Zuo, H., Shi, Z., Hu, X., Wu, M., Guo, Z., and Hussain, A. (2009). Prevalence of metabolic syndrome and factors associated with its components in Chinese adults. Metab. Clin. Exp., 58(8):1102-1108.
