Elsevier

Archives of Medical Research

Volume 35, Issue 1, January–February 2004, Pages 76-81
Archives of Medical Research

Original article
High prevalence of metabolic syndrome in Mexico

https://doi.org/10.1016/j.arcmed.2003.06.006Get rights and content

Abstract

Background

Our objective was to describe the prevalence of the metabolic syndrome using World Health Organization (WHO) and National Cholesterol Education Program (NCEP-III) definitions in a population-based survey.

Methods

We performed an analysis of data from a Mexican nationwide, population-based study. The population was composed of 2,158 men and women aged 20–69 years sampled after a 9–12 h fasting period. Prevalence of the metabolic syndrome as defined by the NCEP-III definition and WHO criteria was estimated and case characteristics were assessed.

Results

Age-adjusted prevalence was 13.61% for WHO criteria and 26.6% for the NCEP-III definition. Prevalence was 9.2 and 21.4%, respectively, in subjects without diabetes. Thirty five percent of affected cases were <40 years of age. In addition to criteria used for diagnosis, ca. 90% were either overweight or obese. In cases detected using WHO criteria, antihypertensive treatment or blood pressure reading >140/90 was found in 61.8%. The proportion of subjects who qualified for hypolipemiant treatment was lower: lifestyle modifications were needed in 42.1% and drug therapy was required in 18.9%. The same trends were found for cases detected using the NCEP definition.

Conclusions

Prevalence of the metabolic syndrome in Mexico is high. A large proportion of affected cases qualify for preventive actions for complications of the metabolic syndrome (i.e., weight loss, antihypertensive or hypolipemiant treatment). These results provide data for planning therapeutic programs for Mexican patients with the metabolic syndrome.

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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