First Nationwide Study of the Prevalence of the Metabolic Syndrome and Optimal Cutoff Points of Waist Circumference in the Middle East
The National Survey of Risk Factors for Noncommunicable Diseases of Iran
- Alireza Delavari, MD1,
- Mohammad Hossein Forouzanfar, MD, MPH, PHD1,2,
- Siamak Alikhani, MD, MPH3,
- Afsaneh Sharifian, MD4 and
- Roya Kelishadi, MD5
- 1Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran;
- 2Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran;
- 3Ministry of Health and Medical Education, Tehran, Iran;
- 4Kordestan Digestive Research Center, Kordestan University of Medical Sciences, Sanandaj, Iran;
- 5Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
- Corresponding author: Roya Kelishadi, kelishadi{at}med.mui.ac.ir.
Abstract
OBJECTIVE The purpose of this study was to provide the first national estimate on the prevalence of the metabolic syndrome and its components and the first ethnic-specific cutoff point for waist circumference in the Eastern Mediterranean Region.
RESEARCH DESIGN AND METHODS This national survey was conducted in 2007 on 3,024 Iranians aged 25–64 years living in urban and rural areas of all 30 provinces in Iran. The metabolic syndrome was defined by different criteria, namely the definition of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), the International Diabetes Federation (IDF) criteria, and the modified definition of the NCEP/ATP III (ATP III/American Heart Association [AHA]/National Heart, Lung, and Blood Institute [NHLBI]).
RESULTS The age-standardized prevalence of the metabolic syndrome was about 34.7% (95% CI 33.1–36.2) based on the ATP III criteria, 37.4% (35.9–39.0%) based on the IDF definition, and 41.6% (40.1–43.2%) based on the ATP III/AHA/NHLBI criteria. By all definitions, the prevalence of the metabolic syndrome was higher in women, in urban areas, and in the 55- to 64-year age-group compared with the prevalence in men, in rural areas, and in other age-groups, respectively. The metabolic syndrome was estimated to affect >11 million Iranians. The optimal cutoff point of waist circumference for predicting at least two other components of the metabolic syndrome as defined by the IDF was 89 cm for men and 91 cm for women.
CONCLUSIONS The high prevalence of the metabolic syndrome with its considerable burden on the middle-aged population mandates the implementation of national policies for its prevention, notably by tackling obesity. The waist circumference cutoff points obtained can be used in the region.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received October 1, 2008.
- Accepted March 4, 2009.
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Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
- © 2009 by the American Diabetes Association.
