ArticlesPrevalence of the metabolic syndrome and overweight among adults in China
Introduction
Cardiovascular disease is the leading cause of mortality worldwide.1 China and other economically developing countries have experienced a cardiovascular disease epidemic in recent decades, while mortality from cardiovascular disease has fallen in economically developed countries.1, 2 Furthermore, during the next 20 years, cardiovascular disease morbidity and mortality are predicted to increase in China.3, 4 As a result of economic growth and associated sociodemographic changes, the burden from infectious diseases has diminished in China and other economically developing countries, but changes in lifestyle and diet have led to an increase in life expectancy and an increased burden of cardiovascular disease and other chronic diseases.4, 5, 6
Obesity is an important modifiable risk factor for cardiovascular disease, including type 2 diabetes, hypertension, hypercholesterolaemia, coronary heart disease, and stroke.7 Excess bodyweight is also associated with an increased risk for development of other adverse health consequences, such as osteoarthritis, gall bladder disease, and some cancers.8, 9 The metabolic syndrome is characterised by a clustering of cardiovascular risk factors, including abdominal obesity, raised blood pressure and glucose concentration, and dyslipidaemia. The syndrome is associated with the development of diabetes, cardiovascular, and kidney disease,10, 11, 12, 13 and an increased risk for mortality from cardiovascular disease and all causes.14
The metabolic syndrome and overweight are becoming increasingly common in economically developed countries, as shown by emerging prevalence data.15, 16 Some evidence suggests that overweight is also increasing in economically developing countries.17 However, few data exist on the metabolic syndrome in economically developing countries. We aimed to estimate the prevalence of the metabolic syndrome and overweight in the general adult population in China and to examine distributions of these problems by geographic region and urbanisation.
Section snippets
Study population
The International Collaborative Study of Cardiovascular Disease in ASIA (InterASIA) was a cross-sectional study of cardiovascular disease risk factors in nationally representative samples of the general adult population in China. A four-stage stratified sampling method was used. In stage one, 31 provinces (and municipalities) were stratified into northern and southern China, as divided by the Yangtze River. In addition to the municipalities of Beijing in northern China and Shanghai in southern
Results
Characteristics of the study participants are shown in table 1. Men and women residents of northern China had higher systolic and diastolic blood pressure, bodyweight, body-mass index, waist circumference, total and LDL-cholesterol, and fasting plasma glucose than their counterparts in southern China (p<0·0001 for all comparisons). Bodyweight, body-mass index, waist circumference, total and LDL-cholesterol, triglycerides, and fasting plasma glucose were significantly higher in urban than in
Discussion
The InterASIA results indicate that 64million (or 13·7%) adults aged 35–74 years in China have the metabolic syndrome as defined by ATP III. Additionally, nearly 38% of men and 33% of women have one component of the metabolic syndrome. When we modified the ATP III criteria on the basis of recommendations for Asian populations, the number of adults aged 35–74 years in China with the metabolic syndrome increased to 71million (or 15·1%). The results from this study also show that an estimated
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