Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
J Prev Med Public Health. 2023 Jan;56(1):50-58. doi: 10.3961/jpmph.22.373. Epub 2023 Jan 6.
Socioeconomic inequality in metabolic syndrome (MetS) remains poorly understood in Iran. The present study examined the extent of the socioeconomic inequalities in MetS and quantified the contribution of its determinants to explain the observed inequality, with a focus on middle-aged adults in Iran.
This cross-sectional study used data from the Ravansar Non-Communicable Disease cohort study. A sample of 9975 middle-aged adults aged 35-65 years was analyzed. MetS was assessed based on the International Diabetes Federation definition. Principal component analysis was used to construct socioeconomic status (SES). The Wagstaff normalized concentration index (CIn) was employed to measure the magnitude of socioeconomic inequalities in MetS. Decomposition analysis was performed to identify and calculate the contribution of the MetS inequality determinants.
The proportion of MetS in the sample was 41.1%. The CIn of having MetS was 0.043 (95% confidence interval, 0.020 to 0.066), indicating that MetS was more concentrated among individuals with high SES. The main contributors to the observed inequality in MetS were SES (72.0%), residence (rural or urban, 46.9%), and physical activity (31.5%).
Our findings indicated a pro-poor inequality in MetS among Iranian middle-aged adults. These results highlight the importance of persuading middle-aged adults to be physically active, particularly those in an urban setting. In addition to targeting physically inactive individuals and those with low levels of education, policy interventions aimed at mitigating socioeconomic inequality in MetS should increase the focus on high-SES individuals and the urban population.
在伊朗，代谢综合征（MetS）的社会经济不平等问题仍未得到充分理解。本研究旨在评估 MetS 存在的社会经济不平等程度，并量化其决定因素对观察到的不平等现象的贡献，重点关注伊朗的中年人群。
本横断面研究使用了 Ravansar 非传染性疾病队列研究的数据。对年龄在 35-65 岁的 9975 名中年成年人进行了样本分析。根据国际糖尿病联合会的定义评估 MetS。采用主成分分析构建社会经济地位（SES）。采用 Wagstaff 归一化集中指数（CIn）来衡量 MetS 中社会经济不平等的程度。进行分解分析以确定和计算 MetS 不平等决定因素的贡献。
样本中 MetS 的比例为 41.1%。存在 MetS 的 CIn 为 0.043（95%置信区间，0.020-0.066），表明 MetS 在 SES 较高的个体中更为集中。观察到的 MetS 不平等的主要决定因素是 SES（72.0%）、居住（农村或城市，46.9%）和身体活动（31.5%）。
我们的研究结果表明，伊朗中年成年人的 MetS 存在有利于穷人的不平等现象。这些结果强调了促使中年成年人进行身体活动的重要性，特别是那些居住在城市环境中的人。除了针对身体活动不足和教育程度较低的个体外，旨在减轻 MetS 社会经济不平等的政策干预措施应更加关注高 SES 个体和城市人口。
