A prospective study of determinants of the metabolic syndrome in adults

Background and aim: Few studies have prospectively examined the development of the metabolic syndrome and comprehensive set of risk factors in a cohort. The objective of this study was to evaluate determinants of the metabolic syndrome in adults in a prospective study. Methods and results: In this population-based cohort study, a representative sample of 410 subjects (184 men and 226 women), aged 18-74 years, free of the metabolic syndrome at baseline, were studied. In the subsequent 3.5 years metabolic syndrome, defined according to ATP III guidelines, developed in 71 subjects (33men and 38 women) The best determinants of metabolic syndrome were hypertension [odds ratio (OR) by quartiles: 1, 1.2, 1.6, 4.2, p for trend <0.05], waist circumference (1, 1.1, 2, 5.3, p for trend <0.05), triglyceride (1, 1, 2, 3, p for trend <0.05) and HDL cholesterol (1, 0.4, 0.4, 0.3, p for trend <0.05). A prominent dose-response relationship across the carbohydrate and fat intake categories and the odds of metabolic syndrome was observed in univariate analysis. In multivariate analysis high waist circumference was the optimum predictor [OR 8 (4-12.2)]. Conclusion: This report confirms importance of blood pressure, waist circumference and lipid measurements in risk stratification of metabolic syndrome in adulthood. Interventions that address obesity and reduce waist circumference and an appropriate diet may reduce the incidence of the metabolic syndrome in adults. (C) 2007 Published by Elsevier B.V.