The metabolic syndrome and high C-reactive protein: prevalence and differences by sex in a southern-European population-based cohort

Background To evaluate the prevalence of the metabolic syndrome (MS) and its components in a population-based cohort, and to analyse the association between gender, environmental conditions, C-reactive protein (CRP), and the syndrome. Methods Out of 1877 subjects aged 45-64, who represented all the patients of six family physicians, representative of the sanitary districts of Asti (northwestern Italy), 88% accepted to participate in an interview on personal habits, and several clinical and laboratory measurements. Results The MS (National Cholesterol Education Program criteria) was present in 24% of males and 22% of females. Males had a significantly higher percentage of hyperglycaemia, hypertension, hypertriglyceridemia, whereas females had a higher prevalence of central obesity and low HDL-cholesterol. In a multiple logistic regression model, the MS was significantly associated with increasing age, BMI, and > 30 g/day alcohol intake (OR = 1.42; 95% Cl 1.27-1.58), and negatively to higher education level (OR = 0.52; 95% Cl 0.28-0.99) and moderate exercise (OR = 0.65; 95% Cl 0.57-0.76). CRP levels are highly correlated to BMI and the components of the syndrome. The association between CRP and the MS remains significant in women only, in a multivariate analysis, after multiple adjustments (OR = 1.73; 95% CI 1.42-2.11). Higher CRP levels, correlated to smoking and, inversely, to alcohol intake, identify a further 12% of the cohort at higher cardiovascular risk. Conclusions The MS affects more than 20% of this middle-aged cohort, but more than 30%, with higher CRP levels are at high cardiovascular risk. Healthier lifestyle habits are inversely associated with the MS and CRP levels, suggesting the need for strategies and their implementation in the general population. Copyright (c) 2005 John Wiley & Sons, Ltd.