InterASIA Collaboration Group: Prevalence of the metabolic syndrome and overweight among adults in China

Tulane University, New Orleans, Louisiana, United States
The Lancet (Impact Factor: 45.22). 04/2005; 365(9468):1398-405. DOI: 10.1016/S0140-6736(05)66375-1
Source: PubMed


The metabolic syndrome and obesity are major risk factors for cardiovascular disease. Little information exists on the prevalence of the metabolic syndrome in China. We aimed to provide up-to-date estimates of the prevalence of the metabolic syndrome and overweight in the general adult population in China.
We did a cross-sectional survey in a nationally representative sample of 15,540 Chinese adults aged 35-74 years in 2000-01. Metabolic syndrome was defined according to guidelines from the US National Cholesterol Education Program. Overweight was defined as body-mass index of 25.0 kg/m2 or greater.
The age-standardised prevalence of metabolic syndrome was 9.8% (95% CI 9.0-10.6) in men and 17.8% (16.6-19.0) in women. The age-standardised prevalence of overweight was 26.9% (25.7-28.1) in men and 31.1% (29.7-32.5) in women. The prevalence of the metabolic syndrome and overweight was higher in northern than in southern China, and higher in urban than rural residents.
Our results indicate that a large proportion of Chinese adults have the metabolic syndrome and that overweight has become an important public health problem in China. These findings emphasise the urgent need to develop national strategies for the prevention, detection, and treatment of overweight and the metabolic syndrome, to reduce the societal burden of cardiovascular disease in China.

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    • "Though we only measured 4 of these 5 risk factors, after adjustment for age and gender differences, 9.7% office workers and 12.6% construction workers potentially had at least 3 risk factors for metabolic syndrome (MS). This compares to estimates of general population MS prevalence of 15.7% and 14.2% in European men and women respectively[19]and 9.8% (95% CI 9.0–10.6) in Mainland Chinese men and 17.8% (16.6–19.0) in women[20], though more recent studies report sharply higher rates in Mainland Chinese men (35.1%) and women (32.5%)[21]. Thus the construction workers seem to have lower than average levels of metabolic risk relative to the Mainland Chinese population, but comparable to those of Europeans. "
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    ABSTRACT: Objective: Health needs of different employee subgroups within an industry can differ. We report the results of a workplace cardiopulmonary risk assessment targeting workers and support staff in the construction industry. Methods: A free worksite-based cardiopulmonary risk assessment for 1,903 workers on infrastructural contracts across Hong Kong was initiated in May 2014. Cardiopulmonary risk screening was performed in 60-minute blocks for approximately 30 workers/block with individualized feedback and lifestyle counseling. Risk profiles stratified by occupational roles are differentiated using the χ2-test for categorical and Student's t-test for continuous variables. Results: Most construction workers and clerks/professionals were male (83.2% and 71.2%, respectively) and Chinese (78.7% and 90.9%, respectively). Construction workers were older (mean: 44.9 years, SD 11.5) and less well-educated (6.1% received tertiary education) than clerks/professionals (35.0 years, 10.7; 72.6% received tertiary education), but more likely to be hypertensive (22.6% vs. 15.4%, p<0.001), overweight/obese (71.7% vs. 56.6%, p<0.001), centrally obese (53.1% vs. 35.5%, p<0.001), and have undesirable levels of high-density lipoprotein (41.6% vs. 35.8%, p<0.05) and diabetic levels of non-fasting blood glucose (4.3% vs. 1.6%, p<0.05). Up to 12.6% of construction workers and 9.7% of office clerks/professions had three or more metabolic syndrome risk factors. While construction workers were more likely than clerks/professionals to be daily smokers, they reported better work-related physical activity and diet. Conclusions: Simple worksite health risk screening can identify potentially high-cardiopulmonary-risk construction industry employee subgroups for onward confirmatory referral. Separate cardiopulmonary health promotion strategies that account for the varying lifestyle profiles of the two employee subgroups in the industry appear justified.
    Full-text · Article · Jan 2016 · PLoS ONE
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    • "In rural Australia, the prevalence of MS is very high (Janus et al., 2007). We previously showed that the MS prevalence in the Kazakh population in Xinjiang was 26.7% (Guo et al., 2011), higher than that (16.5%) reported for adults in eight cities and provinces in China (Gu et al., 2005), indicating the unusually high prevalence of MS in the Kazakhs of Xinjiang. Epidemiological studies have reported that environmental factors such as lack of physical activity and high-fat food intake contribute to the development of MS. "
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    ABSTRACT: The aim of this study was to assess the association between three FTO polymorphisms (rs9939609, rs8057044, and rs1421085) and metabolic syndrome (MS)-related outcomes in the low-income, rural, nomadic minority Khazakh population in far western China. A total of 489 subjects (245 MS patients, 244 controls) were included in the study and DNA samples were genotyped for the three polymorphisms by matrix-assisted laser desorption/ionization time of flight mass spectrometry. The frequencies of the rs1421085 and rs9939609 genotypes and alleles did not differ significantly between MS patients and control, while the frequencies of rs8057044 G alleles and GG genotypes were higher in MS patients (P < 0.05) than in control subjects (G: 61.16 vs 53.53%, GG: 39.07 vs 29.05%) and the frequencies of rs8057044 A genotypes and alleles were lower (P < 0.05) in MS patients compared with controls (AA: 17.36 vs 21.99%, A: 38.84 vs 46.47%). Risk analysis of the rs8057044 polymorphism revealed individuals with GA and GG genotypes to have 1.112 and 1.731 times higher risks of developing MS than those with the AA genotype, respectively, while the G allele was found to be associated with a 1.367 times higher risk of developing MS compared with the A allele. These apparent correlations, however, did not hold true when adjusted for BMI. Weight, WC, HC, and BMI differed significantly between rs8057044 GG and AA+GA genotypes (P < 0.05).
    Preview · Article · Nov 2015 · Genetics and molecular research: GMR
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    • "In the case of a slightly elevated risk, people receive general lifestyle advice and a link to a detailed lifestyle test. It is known that people with low socio-economic status and health literacy tend to participate less in screening programmes (Bennett, Chen, Soroui, & White, 2009; Berkman, Sheridan, Donahue, Halpern, & Crotty, 2011; Dobbins, Simpson, Oldenburg, Owen, & Harris, 1998; Dryden, Williams, McCowan, & Themessl-Hube, 2012; Guerra, Krumholz, & Shea, 2005; Kobayashi, Wardle, & Von Wagner, 2014; White, Chen, & Atchison, 2008). Different reasons have been suggested, such as invitational materials being difficult to understand (Kobayashi et al., 2014). "
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    ABSTRACT: Objectives To identify the barriers from the perspective of consumers with low health literacy in using risk information as provided in cardiometabolic risk assessments.DesignA qualitative thematic approach using cognitive interviews was employed.Methods We performed interviews with 23 people with low health literacy/health numeracy, who were recruited through (1) several organisations and snowball sampling and (2) an online access panel. Participants completed the risk test of the Dutch national cardiometabolic risk assessment and viewed the personalized information about their risk. They were asked to answer probing questions about different parts of the information. The qualitative data were analysed by identifying main themes related to barriers in using the information, using a descriptive thematic approach.ResultsThe four main themes identified were as follows: (1) People did not fully accept the risk message, partly because numerical information had ambiguous meaning; (2) people lacked an adequate framework for understanding their risk; (3) the purpose and setting of the risk assessment was unclear; and (4) current information tells nothing new: A need for more specific risk information.Conclusions The main barriers were that the current presentation seemed to provoke undervaluation of the risk number and that texts throughout the test, for example about cardiometabolic diseases, did not match people's existing knowledge, failing to provide an adequate framework for understanding cardiometabolic risk. Our findings have implications for the design of disease risk information, for example that alternative forms of communication should be explored that provide more intuitive meaning of the risk in terms of good versus bad.Statement of contribution What is already known on this subject? Online disease risk assessments have become widely available internationally.People with low SES and health literacy tend to participate less in health screening.Risk information is difficult to understand, yet little research has been carried out among people with low health literacy. What does this study add? People with low health literacy do not optimally use risk information in an online cardiometabolic risk assessment.The texts provided in the cardiometabolic risk assessment do not suit to their existing knowledge.The typical risk communication (numbers, bar graph, verbal label) seems to provoke undervaluation of risk.
    Full-text · Article · Jul 2015 · British Journal of Health Psychology
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