Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America.
PLoS One. 2018 Mar 27;13(3):e0192372. doi: 10.1371/journal.pone.0192372. eCollection 2018.
Coronary Artery Disease (CAD) is a leading cause of death and disability in Kerala, India. Metabolic syndrome (MS) is a constellation of established risk factors for CAD. We aimed to estimate the prevalence of MS and evaluate the association between MS and CAD using a community-based sample population.
A cross-sectional community based survey was conducted in urban and rural areas of Kerala in 2011. We included 5063 individuals for analysis. Age standardized prevalence of MS, associated diagnoses (hypertension, diabetes and hypercholesterolemia) and other potential risk factors were assessed for men and women in both urban and rural locations. Univariate and multivariate logistic regression models were developed to identify participant characteristics that are associated with MS.
After standardization for age and adjustment for sex and urban-rural distribution, the prevalence of metabolic syndrome in Kerala was 24%, 29% and 33% for the NCEP ATP III, IDF and AHA/NHLBI Harmonization definitions, respectively. The mean (SD) age of the participants was 51 (14) years, and 60% were women. Women had a higher prevalence of MS than men (28% versus 20% for ATP III, p<0.001). Similarly, participants living in urban areas had higher prevalence of MS than their rural counterparts (26% versus 22%, p<0.001). Elevated body mass index, older age, and female sex were associated with MS in an adjusted multivariate model. The propensity for definite CAD was 1.7 times higher in individuals with MS defined based on ATP III criteria compared to those without MS (Adjusted OR = 1.69; 95% CI: 1.3-2.2, p<0.001).
One of four to one of three adult individuals in Kerala have MS based on different criteria. Higher propensity for CAD in individuals with MS in Kerala calls for urgent steps to prevent and control the burden of metabolic conditions.
冠心病（CAD）是印度喀拉拉邦死亡和残疾的主要原因。代谢综合征（MS）是一组已确定的 CAD 风险因素。我们旨在使用基于社区的样本人群来估计 MS 的流行率，并评估 MS 与 CAD 之间的关联。
2011 年在喀拉拉邦的城市和农村地区进行了一项横断面社区基础调查。我们纳入了 5063 人进行分析。评估了城市和农村地区男性和女性的 MS 相关诊断（高血压、糖尿病和高胆固醇血症）和其他潜在危险因素的年龄标准化患病率。建立了单变量和多变量逻辑回归模型，以确定与 MS 相关的参与者特征。
标准化年龄后，并调整性别和城乡分布，根据 NCEP ATP III、IDF 和 AHA/NHLBI 调和定义，喀拉拉邦代谢综合征的患病率分别为 24%、29%和 33%。参与者的平均（SD）年龄为 51（14）岁，60%为女性。女性 MS 的患病率高于男性（ATP III 为 28%对 20%，p<0.001）。同样，居住在城市地区的参与者的 MS 患病率高于农村地区的参与者（26%对 22%，p<0.001）。调整后的多变量模型显示，较高的体质指数、年龄较大和女性性别与 MS 相关。根据 ATP III 标准，患有 MS 的个体发生明确 CAD 的可能性比没有 MS 的个体高 1.7 倍（调整 OR = 1.69；95%CI：1.3-2.2，p<0.001）。
根据不同标准，喀拉拉邦四分之一至三分之一的成年个体患有 MS。在喀拉拉邦，MS 患者发生 CAD 的倾向较高，迫切需要采取措施预防和控制代谢性疾病的负担。
