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Comparative Study
. 2021 Mar 3;16(3):e0241926.
doi: 10.1371/journal.pone.0241926. eCollection 2021.

A nationwide study of metabolic syndrome prevalence in Iran; a comparative analysis of six definitions

Affiliations
Comparative Study

A nationwide study of metabolic syndrome prevalence in Iran; a comparative analysis of six definitions

Ozra Tabatabaei-Malazy et al. PLoS One. .

Abstract

Introduction: To integrate and execute a proper preventive plan and reduce the risk of non-communicable diseases (NCDs), policy makers need to have access to both reliable data and a unique definition of metabolic syndrome (MetS). This study was conducted on the data collected by cross-sectional studies of WHO's STEPwise approach to surveillance of NCD risk factors (STEPs) to estimate the national and sub-national prevalence rates of MetS in Iran in 2016.

Materials and methods: The prevalence of MetS was estimated among 18,414 individuals aged ≥25 years living in urban and rural areas of Iran using various definition criteria; National Cholesterol Education Program Adult Treatment Panel III 2004 (ATP III), International Diabetes Federation (IDF), American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI), Joint Interim Statement (JIS). Regional IDF (RIDF) and JIS (RJIS) were defined using ethnicity-specific values of waist circumference for the country.

Results: National prevalence rate of MetS based on ATP III, IDF, AHA/NHLBI, JIS, RIDF and RJIS criteria were 38.3% (95% CI 37.4-39.1), 43.5% (42.7-44.4), 40.9% (40.1-41.8), 47.6% (46.8-48.5), 32.0% (31.2-32.9), and 40.8% (40.0-41.7), respectively. The prevalence was higher among females, in urban residents, and those aged 65-69 years. MetS was expected to affect about 18.7, 21.3, 20.0, 23.3, 15.7, and 20.0 million Iranians, respectively, based on ATP III, IDF, AHA/NHLBI, JIS, RIDF and RJIS. The two most common components noted in this population were reduced high-density lipoprotein cholesterol (HDL-C) levels and central obesity.

Conclusion: High prevalence rate of MetS among Iranian adults is alarming, especially among females, urban residents, and the elderly. The JIS definition criteria is more appropriate to determine higher number of Iranians at risk of NCDs. Proper management and prevention of MetS is required to adopt multiple national plans including lifestyle modifications, medical interventions, and public education on NCDs risk factors.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Age trends of MetS among the Iranian population based on sex and area of residence.
Fig 2
Fig 2. Gender and geographical distribution of sub-national prevalence of MetS based on six different definitions (age-standardized).
Fig 3
Fig 3. Geographical distribution of the prevalence of MetS by ATP III 2004.
Fig 4
Fig 4. Geographical distribution of the prevalence of MetS by IDF.
Fig 5
Fig 5. Geographical distribution of the prevalence of MetS by AHA/NHLBI.
Fig 6
Fig 6. Geographical distribution of the prevalence of MetS by JIS.
Fig 7
Fig 7. Geographical distribution of the prevalence of MetS by Regional IDF.
Fig 8
Fig 8. Geographical distribution of the prevalence of MetS by Regional JIS.

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