Lin et al. BMC Public Health 2010, 10:747 http://www.biomedcentral.com/1471-2458/10/747 R E S E A R C H A R T I C L E Open Access Worksite health screening programs for predicting the development of Metabolic Syndrome in middle- aged employees: a five-year follow-up study Yu-Cheng Lin1,2,3, Jong-Dar Chen4, Su-Huey Lo5, Pau-Chung Chen2* Abstract Background: Metabolic syndrome (MetS) management programs conventionally focus on the adults having MetS. However, risk assessment for MetS development is also important for many adults potentially at risk but do not yet fulfill MetS criteria at screening. Therefore, we conducted this follow-up study to explore whether initial screening records can be efficiently applied on the prediction of the MetS occurrence in healthy middle-aged employees. Methods: Utilizing health examination data, a five-year follow-up observational study was conducted for 1384 middle-aged Taiwanese employees not fulfilling MetS criteria. Data analyzed included: gender, age, MetS components, uric acid, insulin, liver enzymes, sonographic fatty liver, hepatovirus infections and lifestyle factors. Multivariate logistic regression was used to estimate the adjusted odds ratios (OR) and 95% confidence interval (CI) of risk for MetS development. The synergistic index (SI) values and their confidence intervals of risk factor combinations were calculated; and were used to estimate the interacting effects of coupling MetS components on MetS development. Results: Within five years, 13% (175 out of 1384) participants fulfilled MetS criteria. The ORs for MetS development among adults initially having one or two MetS components were 2.8 and 7.3, respectively (both p < 0.01), versus the adults having zero MetS component count at screening. Central obesity carried an OR of 7.5 (p < 0.01), which far exceeded other risk factors (all ORs < 2.7). Synergistic effects on MetS development existed between coupling MetS components: 1. High blood pressure plus low-HDL demonstrated an OR of 11.7 (p < 0.01) for MetS development and an SI of 4.7 (95% CI, 2.1-10.9). 2. High blood pressure plus hyperglycemia had an OR of 7.9 (p < 0.01), and an SI of 2.7 (95% CI, 1.2-6.4). Conclusion: MetS component count and combination can be used in predicting MetS development for participants potentially at risk. Worksite MetS screening programs simultaneously allow for finding out cases and for assessing risk of MetS development. Background Metabolic syndrome (MetS) management programs con- ventionally focused on the adults having MetS [1-3]; while risk assessment for MetS development is also important for many middle-aged adults potentially at risk but do not yet fulfill MetS criteria at screening. Risk assessments for MetS development by utilizing data from lifestyle investigations [4,5] or MetS components, such as elevated blood pressure, dyslipidemia and * Correspondence: pchen@ntu.edu.tw 2Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan Full list of author information is available at the end of the article obesity, have been studied in general population surveys [6,7]. In terms of multi-functional applications and bud- get effectiveness for health managements, it is worth to investigate whether the records, such as MetS compo- nent measurements, from a MetS screening program can be further applied on the risk assessment for MetS development. For the large middle-aged working popu- lation, however, there is a lack of comprehensive follow- up survey examining whether 1. The MetS component count, 2. Each individual MetS component or 3. The combinations of individual MetS components are asso- ciated with MetS development. Since periodic routine health examinations are compulsory for workers at © 2010 Lin et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.