ABSTRACT
Background and Aim: Individuals with a normal weight may have metabolic alterations at risk for chronic non-communicable diseases. The prevalence of this condition and associated factors have not been reported in Latin American populations. We aimed to estimate the presence and associated factors of Metabolically Unhealthy Normal Weight (MUNW) in adults from a public program for the control and prevention of chronic diseases in Medellín, Colombia. Methods: Cross-sectional study. Overweight and normal weight were characterized according to the absence or presence of one or more components of the metabolic syndrome, obtaining four phenotypes: Metabolically Healthy Normal Weight (MHNW), MUNW (phenotype of interest), Metabolically Healthy Overweight (MHO), and Metabolically Unhealthy Overweight (MUO). The association of these phenotypes with sociodemographic variables of lifestyles and increased waist circumference was conducted by using logistic regression. Results: In 37,558 individuals (72.7% women), the prevalence of MUNW was 23.3%. Among the additional phenotypes, MUO was found to be more prevalent (71.6%), while MHNW and MHO were very slightly common, 2% and 3.1%, respectively. In a multiple model, the factors associated with MUNW were age over 60 years (trend [OR 1.56 95% CI 0.97-2.52] p-value = 0.066), living in a rural area ([OR 1.58 95% CI 1.09-2.29] p-value = 0.015), and increased waist circumference ([OR 1.68 95% CI 1.45-1.95] p-value < 0.001). Male gender was inversely associated with all phenotypes (P < 0.05). Conclusion: Almost a quarter of the analyzed population presented MUNW. People living in a rural area and over 60 years old were more likely to present MUNW. Men were less likely to present the weight phenotypes studied, although they could have been underrepresented.
ABSTRACT
BACKGROUND: Metabolic syndrome has increased to epidemic levels in low- and middle-income countries. The knowledge on metabolic syndrome and its related diseases constitutes a clinical, epidemiological, and economic challenge of great relevance. The frequency of metabolic syndrome may vary between populations depending on age, sex, lifestyle, and culture; however, in Colombia, there is only little research, and the available studies focus on small populations that do not allow estimating their prevalence and distribution in different sociodemographic groups. We aimed to estimate the prevalence of metabolic syndrome and its association with sociodemographic characteristics in participants attending public chronic disease control programs in Medellin, Colombia, in the year 2018. METHODS: We conducted a cross-sectional study in all patients who participated in a public chronic disease control program. Involved in this study were 68,288 individuals who attended at 10 hospital units and were strategically distributed in the city. The diagnostic criteria of the metabolic syndrome and its components were based on the consensus of the Latin American Diabetes Association. The data on age, sex, blood pressure, weight, height, physical activity, medications, lipid profile, and glycemic and glycosylated hemoglobin levels were obtained for clinical records. The prevalence, Pearson's chi-square test, prevalence ratios (Kato-Katz method), and odds ratios (Woolf method) were estimated with 95% confidence intervals. A multivariate adjustment model was used with a logistic regression model to identify potential confounders using Epidat 4.2 and SPSS® 25.0. RESULTS: The prevalence of the syndrome was 35.4%, with abdominal obesity in 82.3% individuals, hypertension in 48.6%, glucose intolerance in 25.5%, and hypertriglyceridemia in 22%. The prevalence of the syndrome exhibited statistical differences according to the area of residence. It was 15% higher in women; 31% and 59% higher in young and older adults, respectively, than in individuals aged <25 years; 11% and 13% higher in the illiterate population and population with primary studies than in individuals with higher education; and approximately 200 times higher than those who are sedentary. CONCLUSION: A high prevalence of the syndrome and its constitutive factors in the study population demonstrated the importance of controlling it and increasing community-based prevention strategies, prioritizing the identified groups that are at the highest risk.
