This article provides a global overview of the current trends and distribution of metabolic syndrome. Metabolic syndrome (also known as the cardiometabolic syndrome) refers to a cluster of related risk factors for cardiovascular disease that includes abdominal obesity, diabetes, hypertension, and elevated cholesterol.
Data from the World Health Organization suggests 65% of the world's population live in countries where being overweight or obese kills more people than being underweight.Obesity and Overweight." WHO. N.p., n.d. Web. 28 Nov. 2012. <https://www.who.int/mediacentre/factsheets/fs311/en/>. The WHO defines "overweight" as a BMI greater than or equal to 25, and "obesity" as a BMI greater than or equal to 30. Both overweight and obesity are major risk factors for cardiovascular diseases, specifically heart disease and stroke, and diabetes.
The International Diabetes Federation reports that as of 2011, 366 million people have diabetes; this number is projected to increase to over half a billion (estimated 552 million) by 2030."The Global Burden." International Diabetes Federation. N.p., n.d. Web. 28 Nov. 2012. <http://www.idf.org/diabetesatlas/5e/the-global-burden >. 80 percent of people with diabetes live in developing countries and in 2011, diabetes caused 4.6 million deaths and approximately 78,000 children were diagnosed with type 1 diabetes.
Background
Different definitions of the cardiometabolic syndrome have been proposed by different public health organizations, but recently the International Diabetes Federation (IDF), the National Heart, Lung, and Blood Institute (NHLBI), the American Heart Association (AHA), and others proposed a definition for diagnosing the cardiometabolic syndrome that includes the presence of three out of the following five risk factors: Fasting plasma glucose greater than or equal to 100 mg/dL, or undergoing drug treatment for elevated glucose HDL cholesterol less than 40 mg/dL in men or less than 50 mg/dL in women, or undergoing drug treatment for reduced HDL cholesterol Triglycerides greater than or equal to 150 mg/dL, or undergoing drug treatment for elevated triglycerides Waist circumference greater than or equal to in men or in women (in the United States) Blood pressure greater than or equal to 130 mm Hg systolic or 85 mm Hg diastolic, or undergoing drug treatment for hypertension
Approximately 40–46 percent of the world's adult population has the cluster of risk factors that is metabolic syndrome.Alberti, George, Paul Zimmet, and Johnathan Shaw. The IDF Consensus Worldwide Definition of the Metabolic Syndrome. Publication. Ed. Scott M. Grundy. Brussels, Belgium: International Diabetes Federation, 2006. Web. 29 Nov. 2012. <http://www.idf.org/webdata/docs/IDF_Meta_def_final.pdf >. In 2000, approximately 32% of U.S. adults had the metabolic syndrome. In more recent years that figure has climbed to 34%.
People with the cardiometabolic syndrome have twice the likelihood of developing and dying from cardiovascular disease, and more than seven times the risk of developing diabetes, compared to those with no cardiometabolic risk factors.
Africa Diabetes now affects over 14 million people in the central and southern regions of Africa; this number is expected to increase to 28 million people by 2030, according to the IDF Africa."Diabetes at a Glance, 2012 Africa." IDF Africa - Diabetes Update Fact Sheet. International Diabetes Federation - IDF Africa, n.d. Web. 30 Nov. 2012. <http://www.idf.org/sites/default/files/IDF_AFR_5E_Update_FactSheet_0.pdf >. The NGO Project Hope cites lifestyle changes as the primary cause of the increase of diabetes, specifically type 2 diabetes, which seems to correspond with a growing waist line. Lack of physical activity, increased consumption of processed food and unmanaged portion sizes all contribute to the rise of diabetes – a major component of cardiometabolic risk.Lewis, Kim. "Diabetes Explodes in Sub-Saharan Africa." VOA. N.p., 28 Nov. 2012. Web. 28 Nov. 2012. <https://www.voanews.com/a/diabetes-sub-saharan-africa-africa-hopeclinic-projecthope/1554338.html>. In countries where there are food crises, "much of the foods donated from the international community are calorie-dense foods", according to Project Hope's Senior Advisor, Paul Madden. Nutrition education is essential to prevent type 2 diabetes from consuming the continent. The NGO also suggests that in some villages, 70 to 80 percent of the people may not even be aware that they are living with the disease.
Studies published in the Indian Journal of Endocrinology and Metabolism focused on the prevalence of metabolic syndrome and its components in different African populations using various criteria. Reports from Lagos, Nigeria, for instance, showed the prevalence rate of metabolic syndrome as high as over 80% among diabetic patients. The current trend of rising metabolic syndrome in African populations is largely and generally attributed to "adoption of western lifestyle which is characterized by reduced physical activity, substitution of the traditional African diet rich in fruits, and vegetables for the more energy-laden foods".
Europe Currently, more than 55 million people in Europe have been diagnosed with diabetes, according to the IDF; by 2030 this total will rise to 64 million people."Diabetes at a Glance, 2012 Europe." IDF Europe - Diabetes Update Fact Sheet. International Diabetes Federation - IDF Europe, n.d. Web. 30 Nov. 2012. <http://www.idf.org/sites/default/files/IDF_EUR_5E_Update_FactSheet1_0.pdf >. Roughly 8.4% of adults are affected by this disease, which caused 622,114 deaths in the region this year. 33 IDF studies have also concluded that Europe has the highest number of children with type 1 diabetes.
The European Global Cardiometabolic Risk Profile in Patients with Hypertension Disease (GOOD) survey investigated the cardiometabolic risk profile in adult patients with hypertension across 289 locations in four European regions. Across the Northwest, Mediterranean, Atlantic European Mainland and Central Europe zones, demographic, lifestyle, clinical and laboratory data were collected from eligible patients during one clinic visit. In Central Europe 44% of the participants had type 2 diabetes compared with 33% in the Atlantic European Mainland, and 26% in the Northwest and the Mediterranean regions. The study revealed a prevalence of metabolic syndrome affected 68% of Central Europe, 60% of the Atlantic European Mainland, 52% of the Mediterranean regions and 50% of Northwest Europe. Fasting blood glucose, total cholesterol and triglyceride levels were all highest in Central Europe compared with the other three regions. Roughly 80% of the Atlantic European Mainland patients had uncontrolled blood pressure, whereas the other three regions tallied approximately 70-71%. Compared to the Northwest, Mediterranean, and Central Europe regions, declared alcohol consumption was also recorded the highest in the Atlantic European Mainland; exercise was lowest in Central Europe.
The GOOD survey recorded cases of congestive heart failure, left ventricular hypertrophy, coronary artery disease and stable/unstable angina were highest in Central Europe compared with the other regions. Family history of premature stroke or myocardial infarction, stroke, coronary revascularization and transient ischaemic attacks had the highest prevalence in the Atlantic European Mainland. Statistical conclusions indicate that hypertensive patients across Europe exhibit multiple cardiometabolic risk factors, with greater predominance in Central Europe and the Atlantic European Mainland compared with Northwest and Mediterranean regions.
Middle East and North Africa The International Diabetes Federation reports more than 34.2 million people in the Middle East and North Africa have diabetes; this number will rise to 59.7 million by the year 2030 unless counteractive measures are introduced."Diabetes at a Glance, 2012 Middle East and North Africa." IDF MENA - Diabetes Update Fact Sheet. International Diabetes Federation - IDF MENA, n.d. Web. 30 Nov. 2012. <http://www.idf.org/sites/default/files/IDF_MENA_5E_Update_FactSheet.pdf >. In 2012, diabetes caused 356,586 deaths in this region, a zone with the highest prevalence of diabetes in adults (11%) in the world.
Turkey reported a prevalence of 33.9% for metabolic syndrome (MS), with a higher prevalence in women (39.6%) than in men (28%). The survey included random samples from both urban and rural populations in seven geographical regions of Turkey. More than one-third (35.08%) of the participants were obese. Of those tested, 13.66% had hypertension, while those with diabetes mellitus (DM) and MS were 4.16% and 17.91%, respectively. The frequency of hypertension, MS and obesity were higher in females than males; however, DM was higher in males than females. According to the IDF, metabolic syndrome was prevalent in 16.1% of the Saudi Arabian population. In Tunisia, metabolic syndrome incidence was 45.5% based on the IDF criteria. 37.4% of Iranians aging from 25 to 64, living in both urban and rural areas of all 30 provinces in Iran, had MS (based on the IDF definition); results based on the Adult Treatment Panel III (ATPIII)/American Heart Association (AHA)/National Heart, Lung, and Blood Institute (NHLBI) standards suggest 41.6% of the same group of Iranians has metabolic syndrome. MS is estimated to affect more than 11 million Iranians.
North America and the Caribbean Current IDF data proposes more than 38.4 million people in North American and the Caribbean have diabetes and projects this number will increase to 51.2 million by 2030."Diabetes at a Glance, 2012 North America and Caribbean." IDF NAC - Diabetes Update Fact Sheet. International Diabetes Federation - IDF NAC, n.d. Web. 30 Nov. 2012. <http://www.idf.org/sites/default/files/IDF_NAC_5E_Update_FactSheet.pdf >. In 2012, 11% of (or approximately 4.2 million) adults in the NAC Region endured the disease; this year, diabetes was responsible for 287,020 deaths in North America.
The National Center for Biotechnological Information notes the incidence of the metabolic syndrome among Caribbean-born persons in the U. S. Virgin Islands is comparable to that among the population on the mainland of the United States. The groups involved in the study were Hispanic white, Hispanic black, non-Hispanic black born in the U.S. Virgin Islands, and non-Hispanic black born elsewhere in the Caribbean. Hispanic ethnicity was independently associated with an increased risk of having the metabolic syndrome, high triglycerides, and low high density lipoprotein cholesterol levels. Among Caribbean-born persons living in the U.S. Virgin Islands, those who are Hispanic blacks may have a greater risk of cardiovascular disease than do other groups.
United States