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The Metabolic Syndrome in the West Bank Population

An urban-rural comparison

From the Institute of Community and Public Health (H.F.A.-R., A.H., R.G.), Birzeit University, Birzeit, The West Bank, Palestinian Authority; the Institute of General Practice and Community Medicine (H.F.A.-R., A.H., E.B.), University of Oslo, and the Department of Medicine (J.J.), Rikshospitalet, Oslo, Norway; and the Department of Epidemiology and Biostatistics (N.H.G.), School of Medicine, Case Western Reserve University, Cleveland, Ohio.

Address correspondence and reprint requests to Hanan F. Abdul-Rahim, MSc, Institute of Community and Public Health, P.O. Box 14, Birzeit University, Birzeit, West Bank, Palestinian Authority. E-mail: hhalabi{at}birzeit.edu .

OBJECTIVE— To compare the prevalence of components of the metabolic syndrome, including hypertension, abnormal glucose metabolism, dyslipidemia, central obesity, and overall obesity, between a rural and an urban Palestinian West Bank community.

RESEARCH DESIGN AND METHODS— A total of 500 rural and 492 urban men and women aged 30-65 years participated in a community-based cross-sectional survey. Diabetes and impaired glucose tolerance were diagnosed using the oral glucose tolerance test. BMI, waist-to-hip ratio, and blood pressure were measured, and blood samples were taken from each subject. Sociodemographic characteristics were investigated using a questionnaire.

RESULTS— Hypertriglyceridemia, low HDL cholesterol, overall obesity, and smoking were significantly more prevalent in the urban population, whereas central obesity was more prevalent in the rural population. Prevalence of hypertension was not significantly different between the rural and urban populations (25.4 and 21.5%, respectively; P = 0.15). The age-adjusted prevalences of diabetes were high: 11.3% (8.5-14.1 95% CI) and 13.9% (10.8-17.0) in the rural and urban populations, respectively, but not significantly different. In each community, the age-adjusted prevalence of the metabolic syndrome as defined by the World Health Organization was 17%.

CONCLUSIONS— Although no significant differences were found in the prevalences of hypertension and diabetes between the two populations, other components of the metabolic syndrome, namely elevated triglycerides, low HDL cholesterol, and overall obesity, were more prevalent in the urban population. Given the rapid urbanization of the Palestinian population, the implications for a rise in noncommunicable diseases should be a major public health concern.

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