Metabolic Syndrome Stabilizes but Still Affects 50% of Seniors

Marlene Busko

May 20, 2015

New data show that the prevalence of metabolic syndrome in the United States appears to have stabilized between the time periods 2003 to 2012. But a third of US adults still had metabolic syndrome, based on the most recent National Health and Nutritional Examination Survey (NHANES), and almost half of those over 60 were affected.

The newest figures indicate that the overall prevalence of metabolic syndrome rose with age: 18.3% of 20- to 39-year-olds, 33% of 40- to 59-year-olds, and 46.7% of people aged 60 and older had metabolic syndrome.

Understanding updated prevalence trends may be important, given the potential effect of the metabolic syndrome and its associated health complications on the aging US population, and as such the results are "concerning," Dr Maria Aguilar (Alameda Health System-Highland Hospital, Oakland, CA) and colleagues write, in a research letter published in the May 19 issue of the Journal of the American Medical Association.

"If this trend continues, it's going to be a huge public-health problem for our healthcare system," senior author Dr Robert J Wong (Alameda Health System-Highland Hospital) told Medscape Medical News.

Thus, healthcare providers need to be more aggressive in screening patients to detect hypertension, high cholesterol levels, and insulin resistance, and "if you can treat and optimize these factors — the blood pressure, cholesterol, and [prediabetes] — you won't eliminate [metabolic syndrome] but you can dramatically reduce the risk of heart disease, diabetes, and fatty liver," he said.

Trends in Metabolic Syndrome in the Past Decade

Previous NHANES data from 1999 to 2006 showed the prevalence of metabolic syndrome in the United States was 34%, and Dr Aguilar and colleagues aimed to determine whether the prevalence was still the same, using more recent NHANES figures.

They defined metabolic syndrome as having three or more of the following: waist circumference larger than 102 cm (40 inches) in men or larger than 88 cm (34 inches) in women; serum triglycerides of 150 mg/dL or higher; HDL cholesterol below 40 mg/dL in men or below 50 mg/dL in women; blood pressure of 130/85 mm Hg or greater or taking hypertension medications; or fasting plasma glucose of 100 mg/dL or greater or taking medications for type 2 diabetes.

Waist circumference provides a better measure of visceral adiposity than body mass index, Dr Wong noted.

There was no significant difference in the overall prevalence of metabolic syndrome between 2007–2008 and 2011–2012, at 36.1% vs 34.7%, respectively, although the prevalence in women decreased significantly, from 39.4% to 36.6%.

The researchers note that greater awareness of the metabolic syndrome and its health consequences may have contributed to improvements in optimizing treatment of risk factors such as hypertension and diabetes.

"Furthermore, recent NHANES data demonstrate that obesity prevalence in the United States also appears to have stabilized," which may have contributed to the plateau seen in the prevalence of metabolic syndrome, they observe.

Nevertheless, the study does reveal that "a huge proportion of adults are affected by metabolic syndrome (over 30%)," Dr Wong noted.

It also identified ethnic differences. During 2003 to 2012, Hispanics had the highest overall prevalence of metabolic syndrome (35.4%), followed by non-Hispanic whites (33.4%) and blacks (32.7%).

According to Dr Wong, this study once again emphasizes that "better management of comorbid diseases and possibly increased emphasis on lifestyle — a better healthy diet and exercise —can achieve the greatest risk reduction."

The authors report having no relevant financial relationships.

JAMA. 2015;313:1973-1974. Abstract

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