Objectives. Metabolic syndrome (MetS) is a major risk factor of CVD. The aim of the present study is to determine the prevalence of the MetS, its components, and its different profiles according to NCEP-ATP III 2001, IDF 2005, and JIS 2009 definitions in Hammam-Sousse Sahloul Heart Study (HSHS). Study Design. The study involved 1121 participants (364 men and 757 women; sex-ratio？？=？？0.48; mean age？？=？？47.49？±？16.24 years) living in Hammam Sousse city, located in the east of Tunisia. Methods. Anthropometric parameters, blood pressure, lipids levels, glycemia, insulinemia, and body mass index were measured. Statistical analyses were performed by SPSS16.0. Results. The percentage of participants who had MetS defined according to NCEP ATP III, IDF 2005, and JIS 2009 definitions was respectively, 29.5%, 38.4%, and 39.6%. With regard to gender, the prevalence of MetS is higher in men than in women according to IDF 2005 definition (38.5% men versus 38.3% women, ) and according to JIS 2009 definition (41.8% men versus 38.6% women, ), whereas, according to NCEP ATP III definition, the prevalence of MetS is higher in women than in men (30% versus 28.6%, ). The prevalence of MetS increased with increasing age according to the three definitions ( ) and peaked in the oldest age group (≥70 years) according to IDF 2005 and JIS 2009. Furthermore, a significant difference in the prevalence of MetS components according to gender was observed. Indeed, the abdominal obesity is the most frequent MetS compound in women group, but hypertension and low HDL-C are the most frequent in men. In addition, according to the three definitions, the most frequent MetS profile in our study is “higher waist circumference, hypertension, and low HDL-C.” Conclusion. The high prevalence of MetS is a serious public health problem in Hammam-Sousse Sahloul community. Higher waist circumference, hypertension, and low HDL-C were the most frequent profile in our study. 1. Introduction Several risk factors of cardiovascular diseases (CVD), including abdominal obesity, elevated fasting blood glucose, elevated triglycerides, elevated blood pressure, and low high-density lipoprotein (HDL) cholesterol, tend to cluster in individuals [1]. The simultaneous presence of three or more of these factors has been termed the metabolic syndrome (MetS) and is known to promote the development of CVD and type 2 diabetes [2–4]. MetS has become a major worldwide public health problem [5]. Several sets of criteria have been established for the detection of MetS, where many of them have been continually updated. The set
References
[1]
P. W. F. Wilson, W. B. Kannel, H. Silbershatz, and R. B. D'Agostino, “Clustering of metabolic factors and coronary heart disease,” Archives of Internal Medicine, vol. 159, no. 10, pp. 1104–1109, 1999.
[2]
H. Iso, S. Sato, A. Kitamura et al., “Metabolic syndrome and the risk of ischemic heart disease and stroke among Japanese men and women,” Stroke, vol. 38, no. 6, pp. 1744–1751, 2007.
[3]
B. Isomaa, P. Almgren, T. Tuomi et al., “Cardiovascular morbidity and mortality associated with the metabolic syndrome,” Diabetes Care, vol. 24, no. 4, pp. 683–689, 2001.
[4]
S. M. Grundy, J. I. Cleeman, S. R. Daniels et al., “Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement,” Circulation, vol. 112, no. 17, pp. 2735–2752, 2005.
[5]
E. S. Ford, “Prevalence of the metabolic syndrome defined by the international diabetes federation among adults in the U.S.,” Diabetes Care, vol. 28, no. 11, pp. 2745–2749, 2005.
[6]
“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),” The Journal of the American Medical Association, vol. 285, no. 19, pp. 2486–2497, 2001.
[7]
K. G. M. M. Alberti, P. Zimmet, and J. Shaw, “The metabolic syndrome—a new worldwide definition,” The Lancet, vol. 366, no. 9491, pp. 1059–1062, 2005.
[8]
K. G. M. M. Alberti, R. H. Eckel, S. M. Grundy et al., “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, vol. 120, no. 16, pp. 1640–1645, 2009.
[9]
R. H. Eckel, S. M. Grundy, and P. Z. Zimmet, “The metabolic syndrome,” The Lancet, vol. 365, no. 9468, pp. 1415–1428, 2005.
[10]
E. S. Ford, W. H. Giles, and A. H. Mokdad, “Increasing prevalence of the metabolic syndrome among U.S. adults,” Diabetes Care, vol. 27, no. 10, pp. 2444–2449, 2004.
[11]
R. Gupta, P. C. Deedwania, A. Gupta, S. Rastogi, R. B. Panwar, and K. Kothari, “Prévalence du syndrome métabolique dans une population indienne urbaine,” International Journal of Cardiology, vol. 97, pp. 257–261, 2004.
[12]
F. Azizi, P. Salehi, A. Etemadi, and S. Zahedi-Asl, “Prévalence du syndrome métabolique dans une population urbaine: des lipides et du glucoseTéhéran étude,” Diabetes Research and Clinical Practice, vol. 61, pp. 29–37, 2003.
[13]
Q. Qiao, J. Pitk？niemi, J. Tuomilehto et al., “Comparison of different definitions of the metabolic syndrome in relation to cardiovascular mortality in European men and women,” Diabetologia, vol. 49, no. 12, pp. 2837–2846, 2006.
[14]
B. Balkau, M. Vernay, L. Mhamdi et al., “The incidence and persistence of the NCEP (National Cholesterol Education Program) metabolic syndrome. The French D.E.S.I.R. study,” Diabetes & Metabolism, vol. 29, pp. 526–532, 2003.
[15]
R. B. Ervin, “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,” National Health Statistics Reports 13, National Center for Health Statistics, 2009.
[16]
H. Ben Romdhane, H. Haouala, A. Belhani et al., “Epidemiological transition and health impact in Tunisia,” Tunisie Medicale, vol. 83, no. 5, pp. 1–7, 2005.
[17]
F. Harzallah, H. Alberti, and F. Ben Khalifa, “The metabolic syndrome in an Arab population: a first look at the new International Diabetes Federation criteria,” Diabetic Medicine, vol. 23, no. 4, pp. 441–444, 2006.
[18]
R. Bouguerra, L. Ben Salem, H. Alberti et al., “Prevalence of metabolic abnormalities in the Tunisian adults: a population based study,” Diabetes and Metabolism, vol. 32, no. 3, pp. 215–221, 2006.
[19]
M. Allal-Elasmi, S. Haj Taieb, M. Hsairi et al., “The metabolic syndrome: prevalence, main characteristics and association with socio-economic status in adults living in Great Tunis,” Diabetes & Metabolism, vol. 36, no. 3, pp. 204–208, 2010.
[20]
R. Magnani, Sampling Guide: IMPACT Food Security and Nutrition Monitoring Project, ISTI, Arlington, Va, USA, 1997.
[21]
W. T. Friedewald, R. I. Levy, and D. S. Fredrickson, “Estimation of the concentration of low-density lipoprotein cholesterol in plasma without use of the preparative ultracentrifuge,” Clinical Chemistry, vol. 18, no. 6, pp. 499–502, 1972.
[22]
K. G. Alberti and P. Z. Zimmet, “Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation,” Diabetic Medicine, vol. 15, pp. 539–553, 1998.
[23]
A. V. Chobanian, G. L. Bakris, H. R. Black et al., “The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report,” The Journal of the American Medical Association, vol. 289, no. 19, pp. 2560–2572, 2003.
[24]
Expert 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),” The Journal of the American Medical Association, vol. 285, no. 19, pp. 2486–2497, 2001.
[25]
M. A. Cornier, D. Dabelea, T. L. Hernandez et al., “The metabolic syndrome,” Endocrine Reviews, vol. 29, no. 7, pp. 777–822, 2008.
[26]
V. G. Athyros, E. S. Ganotakis, K. Tziomalos et al., “Comparison of four definitions of the metabolic syndrome in a Greek (Mediterranean) population,” Current Medical Research and Opinion, vol. 26, no. 3, pp. 713–719, 2010.
[27]
E. Mannucci, M. Monami, G. Bardini, A. Ognibene, and C. M. Rotella, “National cholesterol educational program and international diabetes federation diagnostic criteria for metabolic syndrome in an Italian cohort: results from the FIBAR study,” Journal of Endocrinological Investigation, vol. 30, no. 11, pp. 925–930, 2007.
[28]
R. Gupta, PC. Deedwania, A. Gupta, S. Rastogi, RB. Panwar, and K. Kothari, “Prévalence du syndrome métabolique dans une population indienne urbaine,” International Journal of Cardiology, vol. 97, pp. 257–261, 2004.
[29]
F. Azizi, P. Salehi, A. Etemadi, and S. Zahedi-Asl, “Prévalence du syndrome métabolique dans une population urbaine: des lipides et du glucose Téhéran étude,” Diabetes Research and Clinical Practice, vol. 61, pp. 29–37, 2003.
[30]
E. S. Ford, W. H. Giles, and W. H. Dietz, “Prevalence of the metabolic syndrome among US adults: findings from the Third National Health and Nutrition Examination Survey,” Journal of the American Medical Association, vol. 287, no. 3, pp. 356–359, 2002.
[31]
B. Balkau, T. Drivsholm, K. Borch-Johnsen et al., “Frequency of the WHO metabolic syndrome in European cohorts, and an alternative definition of an insulin resistance syndrome,” Diabetes & Metabolism, vol. 28, no. 5, pp. 364–376, 2002.
[32]
V. G. Athyros, V. I. Bouloukos, A. N. Pehlivanidis et al., “The prevalence of the metabolic syndrome in Greece: The MetS-Greece Multicentre Study,” Diabetes, Obesity and Metabolism, vol. 7, no. 4, pp. 397–405, 2005.
[33]
H. S. Park, S. M. Kim, J. S. Lee et al., “Prevalence and trends of metabolic syndrome in Korea: Korean national health and nutrition survey 1998–2001,” Diabetes, Obesity and Metabolism, vol. 9, no. 1, pp. 50–58, 2007.
[34]
Y. W. Park, S. Zhu, L. Palaniappan, S. Heshka, M. R. Carnethon, and S. B. Heymsfield, “The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994,” Archives of Internal Medicine, vol. 163, pp. 427–436, 2003.
[35]
M. Ravikiran, A. Bhansali, P. RaviKumar et al., “Prevalence and risk factors of metabolic syndrome among Asian Indians: a community survey,” Diabetes Research and Clinical Practice, vol. 89, no. 2, pp. 181–188, 2010.
[36]
J. A. Al-Lawati, A. J. Mohammed, H. Q. Al-Hinai, and P. Jousilahti, “Prevalence of the metabolic syndrome among Omani adults,” Diabetes Care, vol. 26, no. 6, pp. 1781–1785, 2003.
[37]
Y. Khader, A. Bateiha, M. El-Khateeb, A. Al-Shaikh, and K. Ajlouni, “High prevalence of the metabolic syndrome among Northern Jordanians,” Journal of Diabetes and Its Complications, vol. 21, no. 4, pp. 214–219, 2007.
[38]
L. A. Jaber, M. B. Brown, A. Hammad, Q. Zhu, and W. H. Herman, “The prevalence ofthemetabolic syndrome among Arab Americans,” Diabetes Care, vol. 27, no. 1, pp. 234–238, 2004.
[39]
H. F. Abdul-Rahim, A. Husseini, E. Bjertness, R. Giacaman, N. H. Gordon, and J. Jervell, “The metabolic syndrome in the West Bank population: an urban-rural comparison,” Diabetes Care, vol. 24, no. 2, pp. 275–279, 2001.
[40]
H. Ghannem, “The challenge of preventing cardiovascular disease in Tunisia,” Preventing Chronic Disease, vol. 3, article A13, 2006.
[41]
M. Rguibi and R. Belahsen, “Metabolic syndrome among Moroccan Sahraoui adult women,” American Journal of Human Biology, vol. 16, no. 5, pp. 598–601, 2004.
[42]
M. Hanefeld, C. Koehler, S. Gallo, I. Benke, and P. Ott, “Impact of the individual components of the metabolic syndrome and their different combinations on the prevalence of atherosclerotic vascular disease in type 2 diabetes: the Diabetes in Germany (DIG) study,” Cardiovascular Diabetology, vol. 6, article 13, 2007.
[43]
S. Moebus, C. Balijepalli, C. L？sch et al., “Age- and sex-specific prevalence and ten-year risk for cardiovascular disease of all 16 risk factor combinations of the metabolic syndrome—a cross-sectional study,” Cardiovascular Diabetology, vol. 9, article 34, 2010.
[44]
I. Ben Ammar, J. Ben Slimène, C. Hmida, F. Ben Mami, S. Dakhli, and A. Achour, “P84 prévalence et caractéristiques du syndrome métabolique dans un groupe de patients diabétique,” Diabetes and Metabolism, vol. 35, article 48, 2009.
[45]
A. J. Scheen, “Diabetes mellitus in the elderly: Insulin resistance and/or impaired insulin secretion?” Diabetes and Metabolism, vol. 31, pp. S27–S34, 2005.
[46]
A. Thanopoulou, B. Karamanos, F. Angelico et al., “Epidemiological evidence for the non-random clustering of the components of the metabolic syndrome: multicentre study of the Mediterranean group for the study of diabetes,” European Journal of Clinical Nutrition, vol. 60, no. 12, pp. 1376–1383, 2006.
[47]
C. Van Den Hooven, J. Ploemacher, and M. Godwin, “Metabolic syndrome in a family practice population: prevalence and clinical characteristics,” Canadian Family Physician, vol. 52, no. 8, pp. 982–983, 2006.
