Original articleHigh prevalence of metabolic syndrome in Mexico
Introduction
The metabolic syndrome is a key feature of the pathogenesis of type 2 diabetes. It is also involved in the progression of atherosclerosis and other degenerative processes 1., 2., 3.. The manifestations of this disorder vary widely among individuals. Contradictory results have been common in this field. One possible reason for this are the criteria used for considering the subjects as affected. Absence of a genetic marker has resulted in several diagnostic criteria 4., 5., 6.. Recently, two major attempts to provide a unifying definition were published. In 1998, the World Health Organization (WHO) proposed a set of criteria that included four clinical entities and demonstration of either glucose intolerance or insulin resistance for considering a subject as affected; a slightly different version that used a lower cut-point for definition of arterial hypertension was published in 1999 (4). WHO recommendations have been applied successfully in Caucasian populations (7). In 2001, the National Cholesterol Education Program (NCEP-III) published its third report (8); this report provided a working definition that used only clinical parameters for diagnosis; nearly 24% of the U.S. population fulfilled these diagnostic criteria (9). Systematic use and comparison of these definitions in several ethnic groups will allow detection of their strengths and weaknesses and definition of which is the best prognostic tool for several forms of morbidity and mortality.
In 1993, the Mexican Ministry of Health conducted the National Survey of Chronic Diseases to estimate prevalence of obesity, type 2 diabetes, renal pathology, hypertension, and dyslipidemia. Our objective was to describe prevalence of the metabolic syndrome using WHO and NCEP-III criteria; characteristics of populations detected as abnormal by these two diagnostic criteria were compared.
Section snippets
Population sample
This was a comparative, cross-sectional study that included individuals from cities with populations of >2,500 persons. In a previous report, we described in detail the sampling procedure and population characteristics (10). Briefly, a multistage sampling procedure was used. A random sample of basic geographic statistical units was obtained for each of the 32 Mexican states from a database generated by the Instituto Nacional de Geografı́a y Estadı́stica after the general sampling frame was
Results
The population was composed mainly of subjects <40 years of age; age and gender distribution were representative of Mexican adults (n = 2,158). Mean lipid concentrations were cholesterol 4.8±1.1 mmol/L, triglycerides 2.4±1.8 mmol/L, HDL cholesterol 1.0±0.3 mmol/L, and LDL cholesterol 3.1±0.9 mmol/L. Body mass index (BMI) was 27.09±5.6 kg/m2. Several cardiovascular risk factors were common in this population. Prevalence of high blood pressure (>140/90 mmHg), diabetes, and obesity was 21.8, 8.3,
Discussion
Prevalence of the metabolic syndrome is high in this unbiased Mexican population. Applying our results to the 2000 Mexican Population Census, >6 million cases nationwide may fulfill the WHO definition and ca. 14 million may be considered affected if NCEP-III criteria are used. Even if the more conservative rates are taken as valid, no other chronic disorder (aside from the individual components of the metabolic syndrome) affects a greater number of Mexican adults.
Use of standardized definitions
Acknowledgements
This study was carried out with a grant from the Mexican Health Ministry.
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