Number 13 n May 5, 2009

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

by R. Bethene Ervin, Ph.D., R.D., Division of Health and Nutrition Examination Surveys

Abstract

Objective—The purpose of this study was to examine the prevalence of

individual risk factors for metabolic syndrome as well as the prevalence of

metabolic syndrome in the National Health and Nutrition Examination Survey

(NHANES) 2003–2006.

Methods—The analytic sample consisted of 3,423 adults, 20 years of age

and over, from NHANES 2003–2006. The National Cholesterol Education

Program’s Adult Treatment Panel III (NCEP/ATP III) guidelines were used to

identify adults who met their criteria for metabolic syndrome. Prevalence

estimates were calculated for each risk factor for metabolic syndrome in addition

to the prevalence of metabolic syndrome. Prevalence estimates and odds ratios

were analyzed by sex and by age group, race and ethnicity, and body mass index

(BMI) stratified by sex.

Results—Approximately 34% of adults met the criteria for metabolic

syndrome. Males and females 40–59 years of age were about three times as

likely as those 20–39 years of age to meet the criteria for metabolic syndrome.

Males 60 years of age and over were more than four times as likely and females

60 years of age and over were more than six times as likely as the youngest age

group to meet the criteria. Non-Hispanic black males were about one-half as

likely as non-Hispanic white males to meet the criteria for metabolic syndrome,

while non-Hispanic black and Mexican-American females were about 1.5 times

as likely as non-Hispanic white females to meet the criteria. Overweight males

were about six times as likely and obese males were about 32 times as likely as

normal weight males to meet the criteria. Overweight females were more than

five times as likely and obese females were more than 17 times as likely as

normal weight females to meet the criteria.

Conclusions—These results demonstrate that metabolic syndrome is

prevalent and that it increases with age and with BMI. The prevalence varied by

race and ethnicity but the pattern was different for males and females.

Keywords: National Health and Nutrition Examination Survey (NHANES) c

metabolic syndrome c BMI c abdominal obesity

Introduction

The National Cholesterol Education

Program’s Adult Treatment Panel III

(NCEP/ATP III) report identified

metabolic syndrome as a constellation of

risk factors that increase a person’s risk

of developing cardiovascular disease

(CVD) (1,2). ATP III identified six

components of the metabolic syndrome

that relate to CVD (1,2):

+ Abdominal obesity

+	 Atherogenic dyslipidemia (elevated

triglyceride, small LDL particles, low

HDL cholesterol)

+ Raised blood pressure

+	 Insulin resistance (with or without

glucose intolerance)

+ Proinflammatory state

+ Prothrombotic state

According to ATP III, a diagnosis of the

metabolic syndrome is made when three

or more of the risk factors shown in

Table 1 are present (1,2). The purpose of

this study was to examine the

prevalence of the individual risk factors

for metabolic syndrome as well as the

prevalence of metabolic syndrome by

sex in the National Health and Nutrition

Examination Survey (NHANES)

2003–2006. The prevalence of these risk

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for Disease Control and Prevention 

National Center for Health Statistics 
Page 2 National Health Statistics Reports n Number 13 n May 5, 2009

factors and of metabolic syndrome was

also analyzed by age group, race and

ethnicity, and body mass index (BMI)

stratified by sex.

Methods

Sample population

NHANES is a cross-sectional

nationally representative health and

nutrition examination survey conducted

by the Centers for Disease Control and

Prevention’s National Center for Health

Statistics. The survey design is a

complex, stratified, multistage

probability sample of the U.S. civilian,

noninstitutionalized population.

NHANES 2003–2006 includes over

samples of low-income persons,

adolescents 12–19 years of age, persons

60 years of age and over, AfricanAmerican persons, and MexicanAmerican persons to improve the

precision of the estimates for these

groups.

A total of 13,635 adults 20 years of

age and over were eligible to participate

in NHANES 2003–2006. The survey

includes an interview conducted in the

home and a subsequent health

examination performed at a mobile

examination center (MEC). Of the

eligible sample, 10,020 adults 20 years

of age and over (73%) participated in

the household interview and 9,515

(70%) also participated in the MEC

exam.

Only adults 20 years of age and

over who participated in the household

interview, the MEC exam, and the

morning fasting subsample were

included in the analytic sample

(n=3,959). Pregnant and lactating

females (n=264) were deleted from the

analytic sample. In addition, 272

participants were deleted because they

were missing information or their

answers were incomplete or were

flagged as not reliable. Weighted unit

and item nonresponse analysis indicated

no systematic bias due to gender, age,

race and ethnicity, or BMI. The final

analytic sample consisted of 3,423

adults.

Definition of metabolic

syndrome

The NCEP/ATP III revised

guidelines shown in Table 1 were used

to identify adults in the analytic sample

who had metabolic syndrome (2). In

addition, individuals who reported

currently taking antihypertensive

medication were classified as having

high blood pressure and individuals

currently taking insulin or an oral

hypoglycemic medication were

classified as having diabetes. According

to these guidelines, metabolic syndrome

is defined as the presence of three or

more of these risk factors.

Height, weight, and waist

circumference were all measured in the

MEC using standardized techniques and

calibrated equipment. A certified

phlebotomist drew fasting morning

blood samples from the examinee’s arm

for the lipid and glucose assays.

Standardized techniques were used to

obtain the blood pressure measurements.

The average of up to three brachial

systolic and diastolic blood pressure

readings was used for the systolic and

diastolic blood pressure values. Detailed

descriptions of the anthropometric,

venipuncture, and blood pressure

measurement procedures can be found

in the anthropometry, laboratory, and

physician examination procedures

manuals (3–5).

Descriptive characteristics

The prevalence of the individual

risk factors for metabolic syndrome and

the prevalence of metabolic syndrome

by sex are reported as well as by age

group, race and ethnicity, and BMI

stratified by sex. Crude and age-adjusted

estimates are presented for the total

population. Age-adjusted estimates are

presented for sex, race and ethnicity,

and BMI. Age adjustment was

performed using the direct method of

adjustment to the U.S. resident

population, ages 20 years and over,

estimated by the U.S. Census Bureau in

the year 2000 (6). Age group was

controlled when examining the odds

ratios (OR) for sex, race and ethnicity,

and BMI.

Age was categorized into three

groups based on the recommendations in

the NHANES Analytic Guidelines (7).

These categories were: 20–39 years,

40–59 years, and 60 years of age and

over. These three age categories were

also used in the age-adjustment

procedure.

Results are reported for nonHispanic white persons, non-Hispanic

black persons, and Mexican-American

persons. Individuals who did not

identify themselves as belonging to one

of these categories were not analyzed

separately but were included in the

‘‘Total’’ category.

BMI measures relative weight for

height. BMI was calculated by dividing

weight by height squared (kg/m2

).

Weight categories were created based on

the National Heart, Lung, and Blood

Institute’s classification system (8). The

underweight and normal weight

categories were combined as well as the

obese and extremely obese categories

because of limited sample sizes. The

three categories used in this analysis

were underweight and normal weight

(BMI less than 25), overweight (BMI

25–29.9), and obese and extremely

obese (BMI 30 or greater).

Data analyses

Data were analyzed using SAS for

Windows (release 9.1; SAS Institute

Inc., Cary, N.C.) and SUDAAN (release

9.0; Research Triangle Institute Inc.,

Research Triangle Park, N.C.) statistical

software programs. Sample weights

were included in the estimation process

for all analyses to take into account the

differential probabilities of selection,

nonresponse, and noncoverage. Standard

errors of the percentages were estimated

using Taylor series linearization, a

method that incorporates the sample

weights and accounts for the sample

design (9). The relative standard error

(RSE) is a measure of an estimate’s

reliability. The RSE of an estimate is

obtained by dividing the standard error

of the estimate (SE(r)) by the estimate
National Health Statistics Reports n Number 13 n May 5, 2009	 Page 3

itself (r). This quantity is expressed as a

percentage of the estimate and is

calculated as follows: RSE=100 x

(SE(r)/r). Estimates with large RSEs are

considered unreliable. Estimates with an

RSE of 30% or more are considered

highly unreliable and are not shown

(indicated by an asterisk (*)). Estimates

with an RSE greater than 20% but less

than 30% are shown with asterisks (**).

These estimates may be unreliable and

should be interpreted with caution (7,

10).

Statistical hypotheses were tested at

the p<.05 level of significance using a

two-tailed t statistic. The Bonferroni

method of adjustment was used to adjust

the critical value for the family of

pairwise comparisons across the three

levels for age, race and ethnicity, and

BMI (11). Logistic regression was used

to estimate the odds ratios of metabolic

syndrome by sex and by age group

stratified by sex. Multiple logistic

regression was used to estimate the odds

ratios of metabolic syndrome by race

and ethnicity and BMI stratified by sex

controlling for age group. All

differences described in the findings are

statistically significant unless indicated

otherwise.

Results

Prevalence of risk factors for

metabolic syndrome

+ Abdominal obesity (53%),

hypertension (40%), and

hyperglycemia (39%) were the most

frequently occurring risk factors for

metabolic syndrome, regardless of

whether one examined the crude or

age-adjusted estimates. Smaller

percentages of adults had

hypertriglyceridemia (31%) and low

HDL cholesterol (25%) (Table 2).

+ There were differences in the

prevalence of each of the individual

risk factors by sex. Males had a

higher age-adjusted prevalence of

hypertriglyceridemia, hypertension,

and hyperglycemia than females, but

females had a higher age-adjusted

prevalence of abdominal obesity and

low HDL cholesterol than males

(Table 2).

+	 There were differences in the

prevalence of abdominal obesity,

hypertriglyceridemia, hypertension,

and hyperglycemia by age group for

both sexes. For females, the

prevalence of each of these risk

factors increased with each

succeeding age group. For males, this

pattern was only true for hypertension

and hyperglycemia. In contrast, males

40 years of age and over were more

likely than the youngest age group to

have abdominal obesity, but there was

no increase in the prevalence of

abdominal obesity with age in males

40 years of age and over. Males

40–59 years of age were more likely

than those 20–39 years of age to have

hypertriglyceridemia, but the

prevalence among males 60 years of

age and over was not significantly

different from that of the other two

age groups. There were no significant

associations between low HDL

cholesterol and age group for either

sex (Table 2).

+	 The age-adjusted patterns for race

and ethnicity varied by sex and the

risk factor examined. Non-Hispanic

white and Mexican-American males

had a higher prevalence of

hypertriglyceridemia and low HDL

cholesterol than non-Hispanic black

males. Non-Hispanic white males had

a higher prevalence of abdominal

obesity than non-Hispanic black

males, and non-Hispanic black males

had a higher prevalence of

hypertension than Mexican-American

males. There were no significant

associations between hyperglycemia

and race and ethnicity for males

(Table 2).

+	 Non-Hispanic black and MexicanAmerican females had a higher

prevalence of abdominal obesity and

hyperglycemia than non-Hispanic

white females, while MexicanAmerican females had a higher

prevalence of low HDL cholesterol

than either of the other two race and

ethnic groups. Non-Hispanic black

females had a higher prevalence of

hypertension than the other two race

and ethnic groups, but they had the

lowest prevalence of

hypertriglyceridemia followed by

non-Hispanic white females.

Mexican-American females had the

highest rate of hypertriglyceridemia

(Table 2).

+	 In general, the prevalence of each of

the five risk factors increased as BMI

increased for both sexes (Table 2).

Prevalence of metabolic

syndrome

+	 Both the crude and age-adjusted

estimates indicate that approximately

34% of the population 20 years of

age and over met the criteria for

metabolic syndrome (Table 3). There

was no significant difference in the

prevalence of metabolic syndrome by

sex.

+	 The prevalence of metabolic

syndrome increased with each

succeeding age group for both sexes.

While about 20% of males and 16%

of females under 40 years of age met

the criteria for metabolic syndrome,

41% of males and 37% of females

40–59 years of age and 52% of males

and 54% of females 60 years of age

and over met the criteria. Males and

females 40–59 years of age were

about three times as likely as the

youngest age group to meet the

criteria for metabolic syndrome

(males: OR=2.70; 95% confidence

interval (CI): 1.96–3.73; females:

OR=3.20; 95% CI: 2.32–4.43). Males

60 years of age and over were more

than four times as likely as the

youngest age group to meet the

criteria (OR=4.18; 95% CI: 3.01–

5.79), and females 60 years of age

and over were more than six times as

likely as the youngest age group to

meet the criteria (OR=6.44; 95% CI:

4.75–8.72) (Table 3).

+	 The association between metabolic

syndrome and race and ethnicity

varied by sex. Twenty-five percent of

non-Hispanic black males met the

criteria for metabolic syndrome

compared with 37% of non-Hispanic

white males and were about half as

likely as non-Hispanic white males to

meet the criteria for metabolic

syndrome (OR=0.54; 95% CI:

0.40–0.73). There were no significant

differences in the prevalence of

metabolic syndrome for females
Page 4	 National Health Statistics Reports n Number 13 n May 5, 2009

based on race and ethnicity, but

non-Hispanic black and MexicanAmerican females were about 1.5

times more likely to meet the criteria

for metabolic syndrome than

non-Hispanic white females (Table 3).

+ The prevalence of metabolic

syndrome increased with increasing

BMI for both sexes. While only about

7% of underweight and normal

weight males had three or more risk

factors for metabolic syndrome, 30%

of overweight males and 65% of

obese males met these criteria.

Overweight males were more than six

times as likely as underweight and

normal weight males to meet the

criteria for metabolic syndrome

(OR=6.17; 95% CI: 3.96–9.62), and

obese males were nearly 32 times as

likely to meet this criteria

(OR=31.92; 95% CI: 20.06–50.78).

Slightly more than 9% of

underweight and normal weight

females, 33% of overweight females,

and 56% of obese females had three

or more risk factors for metabolic

syndrome. Overweight females were

nearly 5.5 times as likely as

underweight and normal weight

females to meet the criteria for

metabolic syndrome (OR=5.48; 95%

CI: 3.75–8.02), and obese females

were more than 17 times as likely to

meet this criteria (OR=17.14; 95%

CI: 12.54–23.44) (Table 3).

Conclusions

Based on the NCEP/ATP III

guidelines, a little more than one-third

of the adults in the United States could

be characterized as having metabolic

syndrome. Metabolic syndrome

increased with age but increased even

more dramatically as BMI increased.

The prevalence of metabolic syndrome

varied by race and ethnicity but the

pattern was different for males and

females. Non-Hispanic black males were

less likely than non-Hispanic white

males to have metabolic syndrome but

non-Hispanic black and MexicanAmerican females were more likely than

non-Hispanic white females to have it.

Among the five diagnostic criteria for

metabolic syndrome abdominal obesity,

hypertension, and hyperglycemia were

the most prevalent.

References

1.	 Executive summary of the third

report on the National Cholesterol

Education Program (NCEP) expert

panel on detection, evaluation, and

treatment of high blood cholesterol in

adults (adult treatment panel III).

JAMA 285:2486–97. 2001.

2.	 Grundy SM, Brewer HB, Cleeman

JI, Smith SC, Lenfant C. Definition

of metabolic syndrome. Report of the

National Heart, Lung, and Blood

Institute/American Heart Association

Conference on scientific issues

related to definition. Circulation.

109:433–8. 2004.

3.	 Centers for Disease Control and

Prevention. National Center for

Health Statistics. National Health and

Nutrition Examination Survey.

Anthropometry procedures manual.

Revised January 2004. http://

www.cdc.gov/nchs/data/nhanes/

nhanes_03_04/BM.pdf.

4.	 Centers for Disease Control and

Prevention. National Center for

Health Statistics. National Health and

Nutrition Examination Survey.

Laboratory procedures manual.

January 2004. Available from:

http://www.cdc.gov/nchs/data/nhanes/

nhanes_03_04/lab_pm.pdf.

5.	 Centers for Disease Control and

Prevention. National Center for

Health Statistics. National Health and

Nutrition Examination Survey.

Physician examination procedures

manual. January 2003. Available

from: http://www.cdc.gov/nchs/data/

nhanes/nhanes_03_04/PE.pdf.

6.	 Klein RJ, Schoenborn CA. Age

adjustment using the 2000 projected

U.S. population. Healthy People

Statistical Notes, no 20. Hyattsville,

MD: National Center for Health

Statistics. 2001.

7.	 U.S. Department of Health and

Human Services. NHANES 1999–

2000 addendum to the NHANES III

analytic guidelines. 2002. Available

from: http://www.cdc.gov/nchs/data/

nhanes/guidelines1.pdf.

8.	 National Heart, Lung, and Blood

Institute. Expert panel on the

identification, evaluation, and

treatment of overweight and obesity

in adults. Clinical guidelines on the

identification, evaluation, and

treatment of overweight and obesity

in adults: the evidence report. Obes

Res 6(suppl 2):51S–209S. 1998.

9.	 Wolter KM. Introduction to variance

estimation. New York, NY: SpringerVerlag. 1985.

10. National Center for Health Statistics.

Health, United States, 2007 With

Chartbook on Trends in the Health of

Americans. Hyattsville, MD. 2007.

11. Neter J, Wasserman W, Kutner MH.

Applied linear statistical models.

Regression, analysis of variance, and

experimental designs. pp. 582–4.

Homewood, IL: Richard D. Irwin,

Inc. 1985.
National Health Statistics Reports n Number 13 n May 5, 2009 Page 5

Table 1. ATP III clinical identification of the metabolic syndrome

Risk factor Defining level

Abdominal obesity (waist circumference):
 

Men .................................. >102 cm (>40 in)
 

Women ................................ >88 cm (>35 in)
 

Triglycerides............................... ≥150 mg/dL
 

HDL cholesterol:
 

Men .................................. <40 mg/dL
 

Women ................................ <50 mg/dL
 

Blood pressure ............................. ≥135/≥85 mm Hg
 

Fasting glucose............................. ≥100 mg/dL
 

NOTES: ATP III is Adult Treatment Panel III. Table taken from: Grundy SM, Brewer HB, Cleeman JI, Smith SC, Lenfant C.

Definition of metabolic syndrome. Report of the National Heart, Lung, and Blood Institute/American Heart Association Conference

on scientific issues related to definition. Circulation. 109:433–8. 2004(2).
factors for metabolic syndrome among adults 20 years of age and over by selected characteristics: United States, 2003–2006

Number

of subjects Abdominal obesity Hypertriglyceridemia

Low HDL

cholesterol

High blood pressure

1 or medication use

High fasting

glucose or

medication use

Standard Standard Standard Standard Standard

Percent error Percent error Percent error Percent error Percent error

3,423 53.2 (1.3) 31.4 (1.0) 24.7 (0.9) 40.0 (1.3) 39.0 (1.9) 
 

3,423 52.8 (1.1) 31.2 (1.0) 24.7 (0.9) 39.5 (1.1) 38.6 (1.6) 
 

1,794 44.8 (1.3)a 4 35.6 (1.5)a 21.6 (1.5)a 43.4 (1.4)a 45.8 (1.8)a
 

1,629 60.7 (1.6)b 26.5 (1.1)b 27.8 (1.5)b 35.2 (1.3)b 31.3 (1.7)b
 

Male

607 32.0 (2.2)a 4 29.6 (2.1)a 21.4 (2.5) 24.1 (2.0)a 28.8 (1.8)a

546 52.1 (2.5)b 41.5 (2.5)b 23.0 (1.9) 44.5 (2.7)b 50.3 (3.3)b

641 55.2 (2.4)b 36.7 (2.1)a,b 19.5 (1.3) 74.4 (2.7)c 67.8 (1.9)c967 47.4 (1.4)a 4 36.6 (1.7)a 22.6 (1.9)a 43.5 (1.7)a,b 44.8 (2.2)
 

346 36.0 (2.9)b 21.2 (2.4)b 11.5 (1.6)b 51.3 (2.8)a 40.9 (2.3)
 

364 37.6 (3.6)a,b 43.7 (2.8)a 26.0 (2.8)a 35.5 (2.7)b 49.8 (3.1)
 

532 * * 18.0 (2.2)a **9.4 (1.9)a 32.0 (1.8)a 35.0 (2.7)a
 

701 35.1 (1.8)a 4 37.7 (1.8)b 22.6 (2.7)b 40.3 (2.2)b 45.0 (2.2)b
 

557 94.4 (1.1)b 48.6 (2.7)c 31.3 (3.3)b 57.5 (2.4)c 55.5 (2.0)c
 

Female
 

488 49.8 (2.7)a 4 17.8 (2.0)a 29.4 (2.5) 6.8 (1.2)a 13.4 (1.5)a
 

542 64.1 (2.2)b 27.3 (1.7)b 29.4 (2.4) 43.2 (2.2)b 35.5 (3.0)b
 

599 74.0 (2.6)c 40.1 (3.0)c 22.7 (2.2) 71.0 (2.6)c 55.1 (2.7)c
 846 58.0 (2.3)a 4 27.3 (1.5)a 27.6 (2.1)a 33.0 (1.5)a 28.7 (2.0)a
 

348 76.3 (2.1)b 14.4 (1.8)b 26.8 (2.7)a 53.4 (2.8)b 38.7 (2.4)b
 

306 74.9 (3.3)b 34.6 (2.1)c 39.6 (3.3)b 32.1 (3.0)a 41.7 (3.8)b
 

519 13.6 (1.5)a 4 12.9 (1.3)a 12.9 (1.7)a 26.4 (1.9)a 15.8 (1.7)a
 

474 77.7 (3.1)b 32.3 (3.0)b 30.5 (1.8)b 31.7 (1.9)a 31.2 (2.3)b
 

634 99.6 (0.2)c 36.8 (1.8)b 43.1 (2.8)c 46.8 (2.6)b 46.9 (2.5)c
 

These estimates are considered highly unreliable and are not shown (7,10).
 

% but less than 30%. These estimates may be unreliable and should be interpreted with caution (7,10).
 

o three blood pressure readings.
 

eparately plus respondents with missing BMI values.
 

med using the direct method of adjustment to the 2000 U.S. Census figures.
 

dicate significant differences. Comparisons involving three categories were adjusted for multiple comparisons using the Bonferroni method of adjustment.
 

Page6 National Health Statistics Reportsn Number 13n May 5, 2009
National Health Statistics Reports n Number 13 n May 5, 2009 Page 7

Table 3. Prevalence of metabolic syndrome and odds ratios for prevalence of metabolic syndrome among adults 20 years of age and

over by selected characteristics: United States, 2003–2006

Characteristic Percent

Standard

error

Odds ratio (95%

confidence interval)

Total, crude1...............................

Total, age adjusted1,2 .........................

34.4

34.0

(1.3)

(1.1)

– – –

– – –

– – –

– – –

Sex2

Male ...................................

Female ..................................

35.1

32.6

(1.3)

(1.6)

1.00

0.89

– – –

(0.73 to 1.07)

Male

Age

20–39 years ...............................

40–59 years ...............................

60 years and over ...........................

20.3

40.8

51.5

(2.0)a 3

(2.1)b

(3.1)c

1.00

2.70

4.18

– – –

(1.96 to 3.73)

(3.01 to 5.79)

Race and ethnicity2

Non-Hispanic white ..........................

Non-Hispanic black ..........................

Mexican American ...........................

37.2

25.3

33.2

(1.6)a 3

(2.0)b

(2.9)a b

1.00

0.54

0.78

– – –

(0.40 to 0.73)

(0.57 to 1.07)

Body mass index (BMI)2

Underweight and normal weight...................

Overweight ...............................

Obese and extremely obese .....................

6.8

29.8

65.0

(1.1)a 3

(2.0)b

(2.4)c

1.00

6.17

31.92

– – –

(3.96 to 9.62)

(20.06 to 50.78)

Female

Age

20–39 years ...............................

40–59 years ...............................

60 years and over ...........................

15.6

37.2

54.4

(1.8)a 3

(2.6)b

(2.8)c

1.00

3.20

6.44

– – –

(2.32 to 4.43)

(4.75 to 8.72)

Race and ethnicity2

Non-Hispanic white ..........................

Non-Hispanic black ..........................

Mexican American ...........................

31.5

38.8

40.6

(2.2)

(2.1)

(2.5)

1.00

1.44

1.55

– – –

(1.05 to 1.98)

(1.06 to 2.29)

Body mass index (BMI)2

Underweight and normal weight...................

Overweight ...............................

Obese and extremely obese .....................

9.3

33.1

56.1

(0.9)a 3

(2.9)b

(2.6)c

1.00

5.48

17.14

– – –

(3.75 to 8.02)

(12.54 to 23.44)

– – – Category not applicable. 1

Total includes racial and ethnic groups not shown separately plus respondents with missing BMI values. 2

Age adjusted percentages and standard error. The logistic regression models controlled for age group. Reference groups for logistic regression: sex—males; age—20–39 years; race and

ethnicity—Non-Hispanic white; body mass index—underweight and normal weight. 3

p<0.05. Adjusted for multiple comparisons using the Bonferroni method of adjustment when three levels were examined. Letters that are different from each other indicate significant differences.
Page 8 National Health Statistics Reports n Number 13 n May 5, 2009

Suggested citation

Ervin RB. 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; no 13. Hyattsville,

MD: National Center for Health Statistics.

2009.

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source, however, is appreciated.

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