Metabolic Syndrome Among Adult Sri Lankans: A Study

Metabolic syndrome (MS) is the name given to a set of risk factors that predisposes a person to coronary artery disease (CAD), diabetes and stroke. It is also known as cardio-metabolic syndrome, syndrome X and insulin resistance syndrome.

Among the risk factors of MS, obesity, dysglycaemia, dyslipidaemia and hypertension are the most important. There are several other factors implicated in MS such as gene-environment interaction, ethnicity and gender.

The first sign of metabolic syndrome is central adiposity while the core feature that plays a vital role in its pathophysiology is insulin resistance.

South Asians form one fifth of the global population and are among the fastest growing migratory populations in developed countries. The prevalence of MS in USA, Greece and other western countries is much higher than its prevalence in South Asian countries. However, the MS rate among the south Asian immigrants to USA is much higher than that seen in the indigenous Caucasian population. This increase in prevalence is suggested to be the result of adopting a western lifestyle.

The prevalence of MS among south Asian countries such as India, Pakistan, Sri Lanka and Bangladesh is higher than the prevalence in regional Asian countries such as Singapore, Taiwan, China and Japan. It has been predicted that the Indian subcontinent will bear the brunt of nearly a half of the CAD burden in the coming years.

CAD is the leading cause of death in Sri Lanka, which is a middle income, developing south Asian country with a population of over 20 million. Metabolic syndrome is quite prevalent among the Sri Lankans and affects one fourths of the general population.

Data was obtained between August 2005 and September 2006 from people living in nine provinces of Sri Lanka. The factors that were taken into account were gender, age, area of residence, ethnicity, educational status and physical activities.

Height and weight were taken; hip and waist measurements were noted; BMI was calculated; blood tests were done and biochemical analysis was carried out.

It is interesting to note that MS was most observed among the population with high levels of education and monthly household income. In terms of physical activity, MS was seen in 38.8% of inactive people, 33.5% of moderately active and in 21.1% of active people.

Modernization and urbanization have ushered in sedentary habits and unhealthy lifestyles in Sri Lanka. Fast food outlets have mushroomed everywhere and the consumption of non- traditional foods is very common among the urban folks, particularly among the children and young adults.

Age was the strongest risk factor with the correlation between age and MS being highest in women. Higher socio- economic status was a risk factor, as rich people are more used to a comfortable lifestyle that could easily be termed 'sedentary'. Sri Lankan moor ethnicity was identified as a risk factor due to their dietary pattern and different lifestyle. It is also a well-established fact that physical activity among the south Asians is very low compared to other ethnic groups.

Some other studies have implicated alcohol consumption and smoking as risk factors.

MS has very serious clinical implications, therefore doctors repeatedly stress upon the need to eat healthy, maintain an optimal weight and be physically active.

Thus the authors conclude that it is important to identify the high-risk groups and initiate holistic, multidisciplinary, and multi-sectoral preventive measures at an individual and societal level, with focus on promoting physical activity and sensible dietary habits to counter the ever-expanding horizon of metabolic syndrome.

Reference:

1. Metabolic syndrome among Sri Lankan adults: prevalence, patterns and correlates

2. Prasad Katulanda et al;

3. Diabetology and Metabolic Syndrome- 2012

Source-Medindia