Prevalence and trends of metabolic syndrome in the adult U.S. population, 1999-2010

Abstract

Objectives: This study sought to characterize the prevalence of metabolic syndrome (MetS), its 5 components, and their pharmacological treatment in U.S. adults by sex and race/ethnicity over time.

Background: MetS is a constellation of clinical risk factors for cardiovascular disease, stroke, kidney disease, and type 2 diabetes mellitus.

Methods: Prevalence estimates were estimated in adults (≥ 20 years of age) from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010 (in 2-year survey waves). The biological thresholds, defined by the 2009 Joint Scientific Statement, were: 1) waist circumference ≥ 102 cm (males adults) and ≥ 88 cm (female adults); 2) fasting plasma glucose ≥ 100 mg/dl; 3) blood pressure of ≥ 130/85 mm Hg; 4) triglycerides ≥ 150 mg/dl; and 5) high-density lipoprotein-cholesterol (HDL-C) <40 mg/dl (male adults) and <50 mg/dl (female adults). Prescription drug use was estimated for lipid-modifying agents, anti-hypertensives, and anti-hyperglycemic medications.

Results: From 1999 and 2000 to 2009 and 2010, the age-adjusted prevalence of MetS (based on biologic thresholds) decreased from 25.5% (95% confidence interval [CI]: 22.5% to 28.6%) to 22.9% (95% CI: 20.3% to 25.5%). During this period, hypertriglyceridemia prevalence decreased (33.5% to 24.3%), as did elevated blood pressure (32.3% to 24.0%). The prevalence of hyperglycemia increased (12.9% to 19.9%), as did elevated waist circumference (45.4% to 56.1%). These trends varied considerably by sex and race/ethnicity. Decreases in elevated blood pressure, suboptimal triglycerides, and high-density lipoprotein-cholesterol prevalence have corresponded with increases in anti-hypertensive and lipid-modifying drugs, respectively.

Conclusions: The increasing prevalence of abdominal obesity, particularly among female adults, highlights the urgency of addressing abdominal obesity as a healthcare priority. The use of therapies for MetS components aligns with favorable trends in their prevalence.

Keywords: CI; CVD; HDL-C; MA; MetS; Mexican-American; NHANES; National Health and Nutrition Examination Survey; T2DM; cardiovascular disease; confidence interval; high-density lipoprotein cholesterol; hypertension; hypertriglyceridemia; metabolic syndrome; metabolic syndrome; type II diabetes mellitus; waist circumference.

Figure 1. Prevalence and trends of the five components of Metabolic Syndrome in the adult US population, 1999–2010

Prevalence and trends of the components of Metabolic Syndrome for US adults aged 20 or older for the total population by sex (first column), by race (second column), and by race and sex (third and fourth columns). Waist circumf.= waist circumference; HDL-C= high-density lipoprotein cholesterol; Non-Mex-Am= Non-Mexican American. Table 1 shows the cut-offs defined as high risk for each indicator. Shaded areas represent 95% confidence intervals.

Figure 2

Prevalence and trends of prescription drug use related to components of Metabolic Syndrome in the adult US population, 1999–2010 Prescription drug use related to components of Metabolic Syndrome for US adults aged 20 or older for the total population by sex (first column), by race (second column), and by race and sex (third and fourth columns). Non-Mex-Am= Non-Mexican American. The online data supplement Table E7 shows the specific medications included as anti-hypertensive, lipid modifying agents, and anti-hyperglycemic. Shaded areas represent 95% confidence intervals.