Metabolic Syndrome Prevalence Increases Among Young Adults

Robert Wong, MD, MS

In an effort to understand current trends in metabolic syndrome, a team of investigators provided an update on prevalence trends in the US from 2011-2016.

Robert Wong, MD, MS, and a colleague used data from the National Health and Nutrition Examination Survey to evaluate trends in metabolic syndrome prevalence among adults at least 20 years old. The survey data were cross-sectional, stratified, and a multistage probability sample of the US population taken from 2011-2016. The unweighted response rates ranged from 58.7-69.5%.

Metabolic syndrome was defined based on the National Cholesterol Education Program’s Adult Treatment Panel III. Patients needed to have at least 3 of the following: waist circumference greater than 102 cm in men or 88 cm in women, triglyceride level greater than 150 mg/dL, high-density lipoprotein cholesterol less than 40 mg/dL in men or less than 50 mg/dL in women, systolic blood pressure at least 130 mm Hg or diastolic blood pressure at least 85 mm Hg or taking hypertension medications, or fasting plasma glucose level at least 100 mg/dL or taking diabetes medications.

Wong and the team used weighted data to estimate the unadjusted prevalence of metabolic syndrome. They stratified the data by age group (20-39, 40-59, and at least 60 years old), sex, and race and ethnicity.

There were 17,048 total participants. The weighted metabolic syndrome prevalence was 34.7% (95% CI, 33.1-36.3). Prevalence was not significantly different among men and women (35.1% vs 34.3%; P=.47) and was highest among “other” race/ethnicity (39%), followed by Hispanic (36.3%) and non-Hispanic white (36%) participants.

There was an increase in the overall crude metabolic syndrome prevalence from 2011-2012 to 2015-2016, but it did not meet statistical significance (from 32.5% [95% CI, 29-36.2] in 2011-2012 to 36.9% [95% CI, 33.9-39.9) in 2015-2016; P=.07). Metabolic syndrome prevalence increased significantly among those in the youngest age cohort (20-39 years old) from 16.2% to 21.3% (P=.02), for women (from 31.7% to 36.6%; P=.04), for Asian participants (from 19.9% to 26.2%; P=.008), and Hispanic participants (from 32.9% to 40.4%; P=.01).

There was a significant increase in prevalence with increasing age among all groups. The prevalence was 19.5% among those 20-39 years old and it increased to 48.6% among those at least 60 years old. There were no significant differences in metabolic syndrome prevalence between men and women in any age group. However, there were significant differences in prevalence among races/ethnicities for each age group. The highest prevalence was among participants who indicated “other” race/ethnicity who were at least 60 years old (64%), followed by Hispanic participants at least 60 years old (57.3%).

While the investigative team found the overall increase in prevalence did not meet statistical significance, there was a significant increase among young adults, and prevalence remained high for those at least 60 years old. The team noted the importance of implementing prevention strategies, including lifestyle modification and the use of medications targeted at those at the highest risk.

The study, “Trends in the Prevalence of Metabolic Syndrome in the United States, 2011-2016,” was published in JAMA Network Open.