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Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

Urban and rural variation in clustering of metabolic syndrome components in the Thai population: results from the fourth National Health Examination Survey 2009

Authors: Wichai Aekplakorn, Pattapong Kessomboon, Rassamee Sangthong, Suwat Chariyalertsak, Panwadee Putwatana, Rungkarn Inthawong, Wannee Nitiyanant, Surasak Taneepanichskul, The NHES IV study group

Published in: BMC Public Health | Issue 1/2011

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Abstract

Background

Information on the distribution of Metabolic syndrome (MetS) and its combinations by urban/rural areas in lower-middle income countries has been limited. It is not clear how the various combinations of MetS components varied by urban/rural population and if particular combinations of MetS are more common. This study aimed to estimate the prevalence of MetS and combinations of MetS components according to sex and urban/rural areas from a nationally representative sample of Thai adults.

Methods

Data from the fourth National Health Examination Survey of 19,256 Thai adults aged 20 years and over were analyzed. MetS was defined using the harmonized criteria of six international expert groups with Asian-specific cut-point for waist circumference.

Results

The prevalence of MetS was 23.2% among adults aged ≥ 20 years (19.5% in men and 26.8% in women). Among men, the prevalence of MetS in urban was higher than those in rural areas (23.1% vs 17.9%, P < 0.05), but among women, the prevalence was higher in rural areas (27.9% vs 24.5%, P < 0.05). Overall, an individual component of low high density lipoprotein (HDL) and hypertriglyceridemia were more common in rural areas, while obesity, high blood pressure and hyperglycemia were more common in urban areas. The most common combination of MetS components in men was the clustering of low HDL, hypertriglyceridemia, and high blood pressure (urban: 3.4% vs. rural: 3.9%, adjusted OR 0.9, 95%CI 0.7, 1.1). Among women, the most common combination was the clustering of obesity, low HDL, and hypertriglyceridemia (urban: 3.9% vs rural: 5.9%, adjusted OR 0.8, 95%CI 0.6, 0.9), followed by the clustering of these three components with high blood pressure (urban: 3.1% vs. rural 4.5%, adjusted OR 0.8, 95%CI 0.7, 0.9).

Conclusion

Metabolic syndrome affects both urban and rural population with different pattern of MetS combinations. Dyslipidemia and obesity were the most common components among women in rural areas, hence, interventions to prevent and control these factors should be strengthened.
Literature
1.
go back to reference Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, Rinfret S, Schiffrin EL, Eisenberg MJ: The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol. 2010, 56: 1113-1132. 10.1016/j.jacc.2010.05.034.CrossRefPubMed Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, Rinfret S, Schiffrin EL, Eisenberg MJ: The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol. 2010, 56: 1113-1132. 10.1016/j.jacc.2010.05.034.CrossRefPubMed
2.
go back to reference Tanomsup S, Aekplakorn W, Sritara P, Woodward M, Yamwong S, Tunlayadechanont S, Tatsaneeyapan A, Lim S, Rajatanavin R: A comparison of components of two definitions of the metabolic syndrome related to cardiovascular disease and all-cause mortality in a cohort study in Thailand. Diabetes Care. 2007, 30: 2138-2140. 10.2337/dc07-0388.CrossRefPubMed Tanomsup S, Aekplakorn W, Sritara P, Woodward M, Yamwong S, Tunlayadechanont S, Tatsaneeyapan A, Lim S, Rajatanavin R: A comparison of components of two definitions of the metabolic syndrome related to cardiovascular disease and all-cause mortality in a cohort study in Thailand. Diabetes Care. 2007, 30: 2138-2140. 10.2337/dc07-0388.CrossRefPubMed
3.
go back to reference Ford ES, Schulze MB, Pischon T, Bergmann MM, Joost HG, Boeing H: Metabolic syndrome and risk of incident diabetes: findings from the European Prospective Investigation into Cancer and Nutrition-Potsdam Study. Cardiovasc Diabetol. 2008, 7: 35-10.1186/1475-2840-7-35.CrossRefPubMedPubMedCentral Ford ES, Schulze MB, Pischon T, Bergmann MM, Joost HG, Boeing H: Metabolic syndrome and risk of incident diabetes: findings from the European Prospective Investigation into Cancer and Nutrition-Potsdam Study. Cardiovasc Diabetol. 2008, 7: 35-10.1186/1475-2840-7-35.CrossRefPubMedPubMedCentral
4.
go back to reference Gu D, Reynolds K, Wu X, Chen J, Duan X, Reynolds RF, Whelton PK, He J: Prevalence of the metabolic syndrome and overweight among adults in China. Lancet. 2005, 365: 1398-1405. 10.1016/S0140-6736(05)66375-1.CrossRefPubMed Gu D, Reynolds K, Wu X, Chen J, Duan X, Reynolds RF, Whelton PK, He J: Prevalence of the metabolic syndrome and overweight among adults in China. Lancet. 2005, 365: 1398-1405. 10.1016/S0140-6736(05)66375-1.CrossRefPubMed
5.
go back to reference Ford ES, Li C, Zhao G: Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US. J Diabetes. 2010, 2: 180-193. 10.1111/j.1753-0407.2010.00078.x.CrossRefPubMed Ford ES, Li C, Zhao G: Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US. J Diabetes. 2010, 2: 180-193. 10.1111/j.1753-0407.2010.00078.x.CrossRefPubMed
6.
go back to reference Kim HM, Kim DJ, Jung IH, Park C, Park J: Prevalence of the metabolic syndrome among Korean adults using the new International Diabetes Federation definition and the new abdominal obesity criteria for the Korean people. Diabetes Res Clin Pract. 2007, 77: 99-106. 10.1016/j.diabres.2006.10.009.CrossRefPubMed Kim HM, Kim DJ, Jung IH, Park C, Park J: Prevalence of the metabolic syndrome among Korean adults using the new International Diabetes Federation definition and the new abdominal obesity criteria for the Korean people. Diabetes Res Clin Pract. 2007, 77: 99-106. 10.1016/j.diabres.2006.10.009.CrossRefPubMed
7.
go back to reference Xu WH, Ruan XN, Fu XJ, Zhu QL, Zhang H, Bai Y, Wu HY, Zhou Y, Qiu H, Sun Q, et al: Prevalence of the metabolic syndrome in Pudong New Area of Shanghai using three proposed definitions among Chinese adults. BMC Public Health. 2010, 10: 246-10.1186/1471-2458-10-246.CrossRefPubMedPubMedCentral Xu WH, Ruan XN, Fu XJ, Zhu QL, Zhang H, Bai Y, Wu HY, Zhou Y, Qiu H, Sun Q, et al: Prevalence of the metabolic syndrome in Pudong New Area of Shanghai using three proposed definitions among Chinese adults. BMC Public Health. 2010, 10: 246-10.1186/1471-2458-10-246.CrossRefPubMedPubMedCentral
8.
go back to reference Kuk JL, Ardern CI: Age and sex differences in the clustering of metabolic syndrome factors: association with mortality risk. Diabetes Care. 2010, 33: 2457-2461. 10.2337/dc10-0942.CrossRefPubMedPubMedCentral Kuk JL, Ardern CI: Age and sex differences in the clustering of metabolic syndrome factors: association with mortality risk. Diabetes Care. 2010, 33: 2457-2461. 10.2337/dc10-0942.CrossRefPubMedPubMedCentral
9.
go back to reference Das M, Pal S, Ghosh A: Rural urban differences of cardiovascular disease risk factors in adult Asian Indians. Am J Hum Biol. 2008, 20: 440-445. 10.1002/ajhb.20757.CrossRefPubMed Das M, Pal S, Ghosh A: Rural urban differences of cardiovascular disease risk factors in adult Asian Indians. Am J Hum Biol. 2008, 20: 440-445. 10.1002/ajhb.20757.CrossRefPubMed
10.
go back to reference Aekplakorn W, Hogan MC, Chongsuvivatwong V, Tatsanavivat P, Chariyalertsak S, Boonthum A, Tiptaradol S, Lim SS: Trends in obesity and associations with education and urban or rural residence in Thailand. Obesity (Silver Spring). 2007, 15: 3113-3121. 10.1038/oby.2007.371.CrossRef Aekplakorn W, Hogan MC, Chongsuvivatwong V, Tatsanavivat P, Chariyalertsak S, Boonthum A, Tiptaradol S, Lim SS: Trends in obesity and associations with education and urban or rural residence in Thailand. Obesity (Silver Spring). 2007, 15: 3113-3121. 10.1038/oby.2007.371.CrossRef
11.
go back to reference Aekplakorn W, Abbott-Klafter J, Premgamone A, Dhanamun B, Chaikittiporn C, Chongsuvivatwong V, Suwanprapisa T, Chaipornsupaisan W, Tiptaradol S, Lim SS: Prevalence and management of diabetes and associated risk factors by regions of Thailand: third National Health Examination Survey 2004. Diabetes Care. 2007, 30: 2007-2012. 10.2337/dc06-2319.CrossRefPubMed Aekplakorn W, Abbott-Klafter J, Premgamone A, Dhanamun B, Chaikittiporn C, Chongsuvivatwong V, Suwanprapisa T, Chaipornsupaisan W, Tiptaradol S, Lim SS: Prevalence and management of diabetes and associated risk factors by regions of Thailand: third National Health Examination Survey 2004. Diabetes Care. 2007, 30: 2007-2012. 10.2337/dc06-2319.CrossRefPubMed
12.
go back to reference Aekplakorn W, Abbott-Klafter J, Khonputsa P, Tatsanavivat P, Chongsuvivatwong V, Chariyalertsak S, Sangwatanaroj S, Tiptaradol S, Lim SS: Prevalence and management of prehypertension and hypertension by geographic regions of Thailand: the Third National Health Examination Survey, 2004. J Hypertens. 2008, 26: 191-198. 10.1097/HJH.0b013e3282f09f57.CrossRefPubMed Aekplakorn W, Abbott-Klafter J, Khonputsa P, Tatsanavivat P, Chongsuvivatwong V, Chariyalertsak S, Sangwatanaroj S, Tiptaradol S, Lim SS: Prevalence and management of prehypertension and hypertension by geographic regions of Thailand: the Third National Health Examination Survey, 2004. J Hypertens. 2008, 26: 191-198. 10.1097/HJH.0b013e3282f09f57.CrossRefPubMed
13.
go back to reference Boonyavarakul A, Choosaeng C, Supasyndh O, Panichkul S: Prevalence of the metabolic syndrome, and its association factors between percentage body fat and body mass index in rural Thai population aged 35 years and older. J Med Assoc Thai. 2005, 88 (Suppl 3): S121-130.PubMed Boonyavarakul A, Choosaeng C, Supasyndh O, Panichkul S: Prevalence of the metabolic syndrome, and its association factors between percentage body fat and body mass index in rural Thai population aged 35 years and older. J Med Assoc Thai. 2005, 88 (Suppl 3): S121-130.PubMed
14.
go back to reference Pongchaiyakul C, Nguyen TV, Wanothayaroj E, Karusan N, Klungboonkrong V: Prevalence of metabolic syndrome and its relationship to weight in the Thai population. JMed Assoc Thai. 2007, 90: 459-467. Pongchaiyakul C, Nguyen TV, Wanothayaroj E, Karusan N, Klungboonkrong V: Prevalence of metabolic syndrome and its relationship to weight in the Thai population. JMed Assoc Thai. 2007, 90: 459-467.
15.
go back to reference Lohsoonthorn V, Lertmaharit S, Williams MA: Prevalence of metabolic syndrome among professional and office workers in Bangkok, Thailand. JMed Assoc Thai. 2007, 90: 1908-1915. Lohsoonthorn V, Lertmaharit S, Williams MA: Prevalence of metabolic syndrome among professional and office workers in Bangkok, Thailand. JMed Assoc Thai. 2007, 90: 1908-1915.
16.
go back to reference Aekplakorn W, Chongsuvivatwong V, Tatsanavivat P, Suriyawongpaisal P: Prevalence of metabolic syndrome defined by the international diabetes Federation and national cholesterol education program criteria among thai adults. Asia Pac J Public Health. 2011, 23: 792-800. 10.1177/1010539511424482.CrossRefPubMed Aekplakorn W, Chongsuvivatwong V, Tatsanavivat P, Suriyawongpaisal P: Prevalence of metabolic syndrome defined by the international diabetes Federation and national cholesterol education program criteria among thai adults. Asia Pac J Public Health. 2011, 23: 792-800. 10.1177/1010539511424482.CrossRefPubMed
17.
go back to reference Aekplakorn W, Chariyalertsak S, Kessomboon P, Sangthong R, Inthawong R, Putwatana P, Taneepanichskul S: Prevalence and management of diabetes and metabolic risk factors in thai adults: the Thai national health examination survey IV, 2009. Diabetes Care. 2011 Aekplakorn W, Chariyalertsak S, Kessomboon P, Sangthong R, Inthawong R, Putwatana P, Taneepanichskul S: Prevalence and management of diabetes and metabolic risk factors in thai adults: the Thai national health examination survey IV, 2009. Diabetes Care. 2011
18.
go back to reference Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC: Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009, 120: 1640-1645. 10.1161/CIRCULATIONAHA.109.192644.CrossRefPubMed Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC: Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009, 120: 1640-1645. 10.1161/CIRCULATIONAHA.109.192644.CrossRefPubMed
19.
go back to reference World Health Organization: International guide for monitoring alcohol consumption and related harm. Book World Health Organization, 2000. International guide for monitoring alcohol consumption and related harm. 2000, City: World Health Organization, Department of Mental Health and Substance Dependence, Noncummunicable Diseases and Mental Health Cluster World Health Organization: International guide for monitoring alcohol consumption and related harm. Book World Health Organization, 2000. International guide for monitoring alcohol consumption and related harm. 2000, City: World Health Organization, Department of Mental Health and Substance Dependence, Noncummunicable Diseases and Mental Health Cluster
20.
go back to reference Bull FC, Maslin TS, Armstrong T: Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health. 2009, 6: 790-804.PubMed Bull FC, Maslin TS, Armstrong T: Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health. 2009, 6: 790-804.PubMed
21.
go back to reference Zuo H, Shi Z, Hu X, Wu M, Guo Z, Hussain A: Prevalence of metabolic syndrome and factors associated with its components in Chinese adults. Metabolism. 2009, 58: 1102-1108. 10.1016/j.metabol.2009.04.008.CrossRefPubMed Zuo H, Shi Z, Hu X, Wu M, Guo Z, Hussain A: Prevalence of metabolic syndrome and factors associated with its components in Chinese adults. Metabolism. 2009, 58: 1102-1108. 10.1016/j.metabol.2009.04.008.CrossRefPubMed
22.
go back to reference Moebus S, Balijepalli C, Losch C, Gores L, von Stritzky B, Bramlage P, Wasem J, Jockel KH: Age-and sex-specific prevalence and ten-year risk for cardiovascular disease of all 16 risk factor combinations of the metabolic syndrome-A cross-sectional study. Cardiovasc Diabetol. 2010, 9: 34-10.1186/1475-2840-9-34.CrossRefPubMedPubMedCentral Moebus S, Balijepalli C, Losch C, Gores L, von Stritzky B, Bramlage P, Wasem J, Jockel KH: Age-and sex-specific prevalence and ten-year risk for cardiovascular disease of all 16 risk factor combinations of the metabolic syndrome-A cross-sectional study. Cardiovasc Diabetol. 2010, 9: 34-10.1186/1475-2840-9-34.CrossRefPubMedPubMedCentral
23.
go back to reference Lee CM, Huxley RR, Woodward M, Zimmet P, Shaw J, Cho NH, Kim HR, Viali S, Tominaga M, Vistisen D, et al: The metabolic syndrome identifies a heterogeneous group of metabolic component combinations in the Asia-Pacific region. Diabetes Res Clin Pract. 2008, 81: 377-380. 10.1016/j.diabres.2008.05.011.CrossRefPubMed Lee CM, Huxley RR, Woodward M, Zimmet P, Shaw J, Cho NH, Kim HR, Viali S, Tominaga M, Vistisen D, et al: The metabolic syndrome identifies a heterogeneous group of metabolic component combinations in the Asia-Pacific region. Diabetes Res Clin Pract. 2008, 81: 377-380. 10.1016/j.diabres.2008.05.011.CrossRefPubMed
24.
go back to reference Aekplakorn W, Hogan MC, Tiptaradol S, Wibulpolprasert S, Punyaratabandhu P, Lim SS: Tobacco and hazardous or harmful alcohol use in Thailand: joint prevalence and associations with socioeconomic factors. Addict Behav. 2008, 33: 503-514. 10.1016/j.addbeh.2007.10.010.CrossRefPubMed Aekplakorn W, Hogan MC, Tiptaradol S, Wibulpolprasert S, Punyaratabandhu P, Lim SS: Tobacco and hazardous or harmful alcohol use in Thailand: joint prevalence and associations with socioeconomic factors. Addict Behav. 2008, 33: 503-514. 10.1016/j.addbeh.2007.10.010.CrossRefPubMed
25.
go back to reference McKeown NM, Meigs JB, Liu S, Rogers G, Yoshida M, Saltzman E, Jacques PF: Dietary carbohydrates and cardiovascular disease risk factors in the Framingham offspring cohort. J Am Coll Nutr. 2009, 28: 150-158.CrossRefPubMed McKeown NM, Meigs JB, Liu S, Rogers G, Yoshida M, Saltzman E, Jacques PF: Dietary carbohydrates and cardiovascular disease risk factors in the Framingham offspring cohort. J Am Coll Nutr. 2009, 28: 150-158.CrossRefPubMed
26.
go back to reference Wang JJ, Li HB, Kinnunen L, Hu G, Jarvinen TM, Miettinen ME, Yuan S, Tuomilehto J: How well does the metabolic syndrome defined by five definitions predict incident diabetes and incident coronary heart disease in a Chinese population?. Atherosclerosis. 2007, 192: 161-168. 10.1016/j.atherosclerosis.2006.04.027.CrossRefPubMed Wang JJ, Li HB, Kinnunen L, Hu G, Jarvinen TM, Miettinen ME, Yuan S, Tuomilehto J: How well does the metabolic syndrome defined by five definitions predict incident diabetes and incident coronary heart disease in a Chinese population?. Atherosclerosis. 2007, 192: 161-168. 10.1016/j.atherosclerosis.2006.04.027.CrossRefPubMed
27.
go back to reference Korwanich K, Sheiham A, Srisuphan W, Srisilapanan P: Opinions of parents, teachers and school board members regarding healthy eating: a qualitative investigation of lay Thai people's perspectives. JMed Assoc Thai. 2007, 90: 1014-1020. Korwanich K, Sheiham A, Srisuphan W, Srisilapanan P: Opinions of parents, teachers and school board members regarding healthy eating: a qualitative investigation of lay Thai people's perspectives. JMed Assoc Thai. 2007, 90: 1014-1020.
28.
go back to reference Roth GA, Fihn SD, Mokdad AH, Aekplakorn W, Hasegawa T, Lim SS: High total serum cholesterol, medication coverage and therapeutic control: an analysis of national health examination survey data from eight countries. Bull World Health Organ. 2011, 89: 92-101. 10.2471/BLT.10.079947.CrossRefPubMed Roth GA, Fihn SD, Mokdad AH, Aekplakorn W, Hasegawa T, Lim SS: High total serum cholesterol, medication coverage and therapeutic control: an analysis of national health examination survey data from eight countries. Bull World Health Organ. 2011, 89: 92-101. 10.2471/BLT.10.079947.CrossRefPubMed
Metadata
Title
Urban and rural variation in clustering of metabolic syndrome components in the Thai population: results from the fourth National Health Examination Survey 2009
Authors
Wichai Aekplakorn
Pattapong Kessomboon
Rassamee Sangthong
Suwat Chariyalertsak
Panwadee Putwatana
Rungkarn Inthawong
Wannee Nitiyanant
Surasak Taneepanichskul
The NHES IV study group
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-854

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