Abstract

Background and Objective: Metabolic syndrome (MetS) is a cluster of metabolic factors. The prevalence of MetS are increasing worldwide. The aim of this study was to determine the prevalence of MetS in obese Saudi population.

Methods: We analyzed 1526 obese participants who are equal to or older than 18 years old. All cases were from the population of the primary health at King Fahad Armed Forces Hospital. All data were collected by personal interview and on the basis of a review of electronic medical records. Physician and nurse interviewers measured and recorded weight (kg) and height (cm). Metabolic risk factors were defined using the 2006 International Diabetes Federation criteria that define elevated triglyceride (TG) as ≥150mg/dL (≥1.7mmol/L) and reduced high density lipoprotein (HDL) as < 40mg/ dL (< 1.03mmol/L) for male and as < 50mg/dL (< 1.29mmol/L) for female. Hypertension (HTN) was defined when the systolic blood pressure was ≥130 mm Hg and/or diastolic blood pressure was ≥85mm Hg in addition to receiving any medication for hypertension. Abnormal glucose metabolism was considered when HbA1c (≥5.7) or when patients were known to have type 2 diabetes (T2DM). A combination of two or more of these risk factors was used to assess cut off values for BMI. Body mass index (BMI) values classified into groups as obese Grade I (BMI=30-34.9kg/m2), obese Grade II (BMI=35.0-39.9kg/m2) and morbidly obese (obese Grade III) (BMI ≥40kg/m2). The total number of cohort were separated on basis of age values into 6 groups: < 30 years, 30-39 years, 40-49 years, 50-59 years, 60-69 years and ≥70 years.

Main results: Of the 1526 participants analyzed, 476 (30.6%) were male and 1059 (69.4%) were female. Age was 51.2±12.8 (minimum 18 years and maximum 105 years). MetS was present in 1060 cases (69.5%) where 328 (30.9%) were male and 732 (69.1%) were female with female to male ratio 2.2:1, P=0.7. Males were significantly older than females in MetS patients (55.0±12.4 vs. 53.0±12.3 respectively, p=0.01). BMI was significantly higher in females than males with MetS patients (36.5±6.0 vs. 34.3±3.7 respectively, p< 0.0001). Female patients with MetS were significantly higher HDL and HbA1c>5.6 or T2DM. Patients with HTN were 18-fold to possess MetS (OR=18.5; 95% confidence interval [CI]=13.0, 26.5, or had been diagnosed with T2DM or having HbA1c>5.6 (OR=15.3; 95% CI=11.6, 20.1), (p< 0.0001), have elevated plasma TG levels (OR=13.8; 95% CI=9.2, 20.7) and were also more likely to have low levels of HDL (OR=9.3; 95% CI=7.1, 12.1). HbA1c>5.6 or T2DM has the highest frequency among the MetS phenotypes 89.2%, p< 0.0001. MetS prevalence is consistently statistically significant with increasing age until the sixth decade then starts to decline (p< 0.0001). Moreover, higher prevalence is among age group 50-59 years of age in females. MetS prevalence was higher among BMI=30-34 group in all patients and both genders. Thus, the mean of BMI among MetS is statistically significant decreased with advanced age in total population and both gender. The mean of BMI among MetS is statistically significant negatively correlated with increasing with advanced age (r=-0.1, p< 0.0001).

Conclusion: The prevalence of metabolic syndrome among obese Saudis is relatively high. Old age and obesity can be regarded as related factors.

Keywords: Metabolic syndrome; Obeisty