Metabolic Syndrome Prevalence Rising Among Younger US Adults

By Lisa Rappaport

June 25, 2020

(Reuters Health) - While the prevalence of metabolic syndrome hasn't climbed significantly among U.S. adults overall in recent years, it has been on the rise among certain groups, including younger adults, a new study suggests.

Researchers examined National Health and Nutrition Examination Survey (NHANES) data from three survey cycles: 2011-2012, 2013-2014, and 2015-2016. The analysis included a total of 17,048 participants aged 20 years and older, including 5,885 people with metabolic syndrome (weighted prevalence 34.7%).

Overall, the crude metabolic syndrome prevalence increased from 32.5% in 2011-2012 to 36.9% in 2015-2016, a trend that did not reach statistical significance.

However, over that same time frame, metabolic syndrome did increase significantly among adults aged 20 to 39 (from 16.2% to 21.3%), women (from 31.7% to 36.6%), Asian participants (from 19.9% to 26.2%), and Hispanic participants (from 32.9% to 40.4%).

Prevalence of metabolic syndrome was highest among survey participants who self-identified as "other" race/ethnicity, at 39%, followed by Hispanic, at 36.3%, and non-Hispanic white, at 36%.

Prevalence also increased sharply with age. During the final survey period, prevalence was 21.3% among adults 20 to 39 years, 42% among adults 40 to 59 years, and 50.4% among adults 60 and older.

It's critical that both patients and clinicians are aware of these findings, said study co-author Dr. Robert Wong, of the division of gastroenterology and hepatology at the Veterans Affairs Palo Alto Healthcare System and Stanford University School of Medicine in California.

"Metabolic syndrome is a systemic disease and is associated with a host of metabolic and cardiovascular complications, which increases morbidity and mortality," Dr. Wong said by email. "Our results emphasize the importance to raise greater awareness of this public health issue, and highlight the need for patients and providers to work together to proactively and effectively screen and optimize diseases associated with metabolic syndrome such as obesity, hypertension, insulin resistance, and dyslipidemia."

Limitations of the NHANES data include nonresponse bias and potential misclassification based on medication use, the study team notes in JAMA. Researchers also lacked data on the severity or control of any individual components of metabolic syndrome.

Although the current study is limited by the nature of the data, NHANES has historically provided valuable insight into public health, said Dr. Leigh Perreault, an associate professor of medicine in the Division of Endocrinology, Metabolism and Diabetes at the University of Colorado Anschutz Medical Campus, in Aurora.

Investigation is warranted into the disproportionate risk for metabolic syndrome in women and people of reported Asian and Hispanic race/ethnicity, Dr. Perreault, who wasn't involved in the study, said by email. And the results are particularly important for younger adults.

"Young people need be aware that acquiring the metabolic syndrome between 20 and 39 years of age places them at very high risk of developing end-stage complications like CVD, cancers and diabetes, resulting in a diminished quality, if not quantity, of life," Dr. Perreault said. "Clinicians should take the opportunity to educate and intervene with young people whenever possible."

SOURCE: JAMA, online June 23, 2020.