The prevalence and characteristics of metabolic syndrome according to different definitions in China: a nationwide cross-sectional study, 2012–2015
Authors: Huang Yilin , Zhang Linfeng , Wang Zengwu , Wang Xin , Chen Zuo , Shao Lan , Tian Ye , Zheng Congying , Chen Lu , Zhou Haoqi , Cao Xue , Tian Yixin , Gao Runlin ,   for the China Hypertension Survey investigators, Hu Liqun , Li Hongqi , Zhang Qi , Yan Guang , Zhu Fangfang , Fang Xianghua , Wang Chunxiu , Guan Shaochen , Wu Xiaoguang , Liu Hongjun , Hou Chengbei , Lei Han , Huang Wei , Zhang Nan , Li Ge , Mu Lihong , Tang Xiaojun , Han Ying , Wang Huajun , Lin Dongjie , Xie Liangdi , Lin Daixi , Yu Jing , Zhang Xiaowei , Liang Wei , Yu Heng , Wang Qiongying , Yang Lan , Feng Yingqing , Huang Yuqing , Wang Peixi , Wang Jiaji , Wang Harry HX , Tang Songtao , Liu Tangwei , Huang Rongjie , Jiang Zhiyuan , Qin Haichan , Liu Guoqin , Liu Zhijun , Rao Wenbo , Chen Zhen , Chu Yalin , Wu Fang , Li Haitao , Ma Jianlin , Chen Tao , Wu Ming , Sun Jixin , Cao Yajing , Liu Yuhuan , Zhang Zhikun , Liu Yanmei , Dong Dejin , Li Guangrong , Guo Hong , Dong Lihang , Zhang Haiyu , Sun Fengyu , Gu Xingbo , Wang Kaijuan , Song Chunhua , Wang Peng , Ye Hua , Nie Wei , Liang Shuying , Huang Congxin , Chen Fang , Zhang Yan , Zhou Heng , Xie Jing , Liu Jianfang , Yuan Hong , Guo Chengxian , Huang Yuelong , Chen Biyun , Zhao Xingsheng , He Wenshuai , Wen Xia , Lu Yanan , Kong Xiangqing , Gui Ming , Xu Wenhua , Lu Yan , Huang Jun , Pan Min , Zhou Jinyi , Wu Ming , Cheng Xiaoshu , Bao Huihui , Huang Xiao , Hong Kui , Li Juxiang , Li Ping , Liu Bin , Wu Junduo , Li Longbo , Yu Yunpeng , Liu Yihang , Qi Chao , Na Jun , Liu Li , Li Yanxia , Pan Guowei , Dong Degang , Qu Peng , Ma Jinbao , Hu Juan , Zhao Fu , Yue Jianning , Zhou Minru , Xu Zhihua , Li Xiaoping , Sha Qiongyue , Ma Fuchang , Chen Qiuhong , Bian Huiping , Mu Jianjun , Guo Tongshuai , Ren Keyu , Chu Chao , Liu Zhendong , Zhang Hua , Diao Yutao , Sun Shangwen , Zhao Yingxin , Ge Junbo , Zhou Jingmin , Jin Xuejuan , Zhou Jun , Li Bao , Zhu Lijun , Zhang Yuean , Wang Gang , Hao Zhihan , Cai Li , Liu Zhou , Yong Zhengping , Wan Shaoping , Jiao Zhenshan , Fan Yuqiang , Gao Hui , Wang Wei , Li Qingkui , Zhou Xiaomei , Chen Yundai , Feng Bin , Zhu Qinglei , Zhou Sansan , Li Nanfang , Zhou Ling , Zhang Delian , Hong Jing , Guo Tao , Zhang Min , Xiao Yize , Guang Xuefeng , Tang Xinhua , Yan Jing , Xu Xiaoling , Yang Li , Jiang Aimin , Yu Wei 
Published: October 2022

Background

Metabolic syndrome (MetS) is characterized by a cluster of signs of metabolic disturbance and has caused a huge burden on the health system. The study aims to explore the prevalence and characteristics of MetS defined by different criteria in the Chinese population.

Methods

Using the data of the China Hypertension Survey (CHS), a nationally representative cross-sectional study from October 2012 to December 2015, a total of 28,717 participants aged 35 years and above were included in the analysis. The MetS definitions of the International Diabetes Federation (IDF), the updated US National Cholesterol Education Program Adult Treatment Panel III (the revised ATP III), and the Joint Committee for Developing Chinese Guidelines (JCDCG) on Prevention and Treatment of Dyslipidemia in Adults were used. Multivariable logistic regression was used to identify factors associated with MetS.

Results

The prevalence of MetS diagnosed according to the definitions of IDF, the revised ATP III, and JCCDS was 26.4%, 32.3%, and 21.5%, respectively. The MetS prevalence in men was lower than in women by IDF definition (22.2% vs. 30.3%) and by the revised ATP III definition (29.2% vs. 35.4%), but the opposite was true by JCDCG (24.4%vs 18.5%) definition. The consistency between the three definitions for men and the revised ATP III definition and IDF definition for women was relatively good, with kappa values ranging from 0.77 to 0.89, but the consistency between the JCDCG definition and IDF definition (kappa = 0.58) and revised ATP III definition (kappa = 0.58) was poor. Multivariable logistic regression showed that although the impact and correlation intensity varied with gender and definition, area, age, education, smoking, alcohol use, and family history of cardiovascular disease were factors related to MetS.

Conclusions

The prevalence and characteristics of the MetS vary with the definition used in the Chinese population. The three MetS definitions are more consistent in men but relatively poor in women. On the other hand, even if estimated according to the definition of the lowest prevalence, MetS is common in China.