Focus Issue: Cardiometabolic Risk
Clinical Research: Metabolic Syndrome
Prevalence and Trends of Metabolic Syndrome in the Adult U.S. Population, 1999–2010

https://doi.org/10.1016/j.jacc.2013.05.064Get rights and content
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Objectives

This study sought to characterize the prevalence of metabolic syndrome (MetS), its 5 components, and their pharmacological treatment in U.S. adults by sex and race/ethnicity over time.

Background

MetS is a constellation of clinical risk factors for cardiovascular disease, stroke, kidney disease, and type 2 diabetes mellitus.

Methods

Prevalence estimates were estimated in adults (≥20 years of age) from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010 (in 2-year survey waves). The biological thresholds, defined by the 2009 Joint Scientific Statement, were: 1) waist circumference ≥102 cm (males adults) and ≥88 cm (female adults); 2) fasting plasma glucose ≥100 mg/dl; 3) blood pressure of ≧130/85 mm Hg; 4) triglycerides ≥150 mg/dl; and 5) high-density lipoprotein-cholesterol (HDL-C) <40 mg/dl (male adults) and <50 mg/dl (female adults). Prescription drug use was estimated for lipid-modifying agents, anti-hypertensives, and anti-hyperglycemic medications.

Results

From 1999 and 2000 to 2009 and 2010, the age-adjusted prevalence of MetS (based on biologic thresholds) decreased from 25.5% (95% confidence interval [CI]: 22.5% to 28.6%) to 22.9% (95% CI: 20.3% to 25.5%). During this period, hypertriglyceridemia prevalence decreased (33.5% to 24.3%), as did elevated blood pressure (32.3% to 24.0%). The prevalence of hyperglycemia increased (12.9% to 19.9%), as did elevated waist circumference (45.4% to 56.1%). These trends varied considerably by sex and race/ethnicity. Decreases in elevated blood pressure, suboptimal triglycerides, and high-density lipoprotein-cholesterol prevalence have corresponded with increases in anti-hypertensive and lipid-modifying drugs, respectively.

Conclusions

The increasing prevalence of abdominal obesity, particularly among female adults, highlights the urgency of addressing abdominal obesity as a healthcare priority. The use of therapies for MetS components aligns with favorable trends in their prevalence.

Key Words

hypertension
hypertriglyceridemia
metabolic syndrome
waist circumference

Abbreviations and Acronyms

CI
confidence interval
CVD
cardiovascular disease
HDL-C
high-density lipoprotein cholesterol
MA
Mexican-American
MetS
metabolic syndrome
NHANES
National Health and Nutrition Examination Survey
T2DM
type II diabetes mellitus

Cited by (0)

Dr. Harhay has received training grants (5T32DK007006-38 and F32DK096758-01) from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Dr. Beltrán-Sánchez has received a training grant (T32AG00037) from the National Institute on Aging (NIA). All other authors have reported that that they have no relationshops relevant to the contents of this paper to disclose. Drs. Beltrán-Sánchez and Harhay contributed equally to this work.