Abstract
Objective:
To determine: (a) whether the components of metabolic syndrome (MetS) cluster more frequently than predicted by chance alone and (b) whether increased risk for MetS is associated also with values of each component below, but close to the cutoff points defining MetS.
Research design and methods:
Anthropometrical and biochemical measurements were performed and a dietary questionnaire was filled-in in 1833 randomly selected non-diabetic subjects, 916 men and 917 women, 20–74 years old, in nine centres in five Mediterranean countries. The prevalence of MetS and of possible combinations of its individual components was measured. The expected frequencies of the above combinations were calculated according to the mathematical formula of probabilities.
Results:
The overall prevalence of MetS was 27.2%, but varied greatly among countries, from 5.8% in Algeria to 37.3% in Greece. The observed prevalence of each combination diagnostic of MetS was higher than the expected by chance. Thus, the observed overall prevalence of MetS was also higher than the expected, 27.2 vs 24.0%, P=0.03. Furthermore, for each individual component (except high-density lipoprotein), as values in the normal range, approached the cutoff point, the risk of having MetS (i.e. clustering of the other components) increased significantly (odds ratio 2.2–4.6, P<0.001).
Conclusions:
The MetS is not related to the Mediterranean type of diet and its prevalence varies greatly among five Mediterranean countries. The clustering of the components defining the MetS is not due to chance and moreover even ‘high normal’ levels of each component confer increased risk for the syndrome.
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Acknowledgements
We thank all the subjects who took part in this study. The study is part of the MultiCentre Nutritional Study of the Mediterranean Group for the Study of Diabetes (MGSD). We thank Ms E Antoniadou and Ms M Panagiotopoulou for secretarial support and Ms P Maraki for laboratory assistance.
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Guarantors: B Karamanos.
Contributors: AT and BK conducted the statistical analysis and wrote the intial draft. All authors participated in the design, interpretation and writing up of the research work.
Participating centres
Professor B Karamanos (Co-ordinator), A Thanopoulou, D Roussi
Diabetes Centre, 2nd Medical Department, Athens University Medical School, Hippokration Hospital, Athens, Greece
Professor F Angelico, M Del Ben, A Barbato
Department of Clinics and Applied Medical Therapy, University ‘La Sapienza’, Rome, Italy
Professor S Assaad Khalil
Department of Internal Medicine, Alexandria Faculty of Medicine, Alexandria, Egypt
Professor P Djordjevic, V Dimitrijevic-Sreckovic, F Canovic
Diabetes Centre, Institute for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Belgrade, Yugoslavia.
Professor N Katsilambros
Diabetes Centre, 1st Department of Propedeutic Medicine, Athens University School of Medicine, Laiko General Hospital, Athens, Greece
Dr I Migdalis
Diabetes Centre, ‘ÍÉÌÔS’ Hospital, Athens, Greece
Dr M Mrabet, S Zarat, A Bentounsi
Service de Medicine Interne ‘A’ CHU Oran, Algeria
Dr M Petkova
Diabetes Centre ‘St Luca’, Sofia, Bulgaria
Professor MT Tenconi, C Gallotti
Dipartimento di Medicina Preventiva, Occupazionale e di Communita. Sezione di Igiene. Universita degli studi di Pavia, Italy
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Thanopoulou, A., Karamanos, B., Angelico, F. et al. Epidemiological evidence for the non-random clustering of the components of the metabolic syndrome: multicentre study of the Mediterranean Group for the Study of Diabetes. Eur J Clin Nutr 60, 1376–1383 (2006). https://doi.org/10.1038/sj.ejcn.1602467
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DOI: https://doi.org/10.1038/sj.ejcn.1602467
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