Effects of smoking, alcohol, exercise, education, and family history on the metabolic syndrome as defined by the ATP III

Introduction: Although several environmental factors are known to have diverse effects on the development of the metabolic syndrome, few studies have examined their relevance to Asians. Methods: We gathered data from 4341 subjects on smoking, alcohol drinking, exercise, family history and education level by a self-administered questionnaire. The components of the metabolic syndrome as defined by the ATP III report were examined. Results: The multivariate-adjusted odds ratio of hypertriglyceridemia was 1.4 (95% Cl 1.0-1.8) and of low HDL-C was 1.9 (95% CI 1.3-2.6) in subjects who smoked more than 20 pack-years compared to nonsmokers. The relative risk of developing the metabolic syndrome in smokers (more than 20 pack-years) was 1.9 (95% Cl 1.1-3.7) compared to nonsmokers. Alcohol consumption had a protective effect against low HDL-C (adjusted OR 0.6-0.2). The relative risk of the metabolic syndrome was 1.7 (95% Cl 0.9-2.8) for lack of exercise, 1.5 (95% CI 1.1-2.1) for a positive family history and 2.0 (95% Cl 1.2-3.4) in those with no or an elementary school education versus university graduation. Conclusion: Since subjects with a low education level and a family history had an elevated risk for the metabolic syndrome and thus for developing cardiovascular disease, particular attention should be paid to these subjects. (C) 2004 Elsevier Ireland Ltd. All rights reserved.