study was carried out to assess the prevalence of metabolic syndrome (MS) among
Sri Lankan adults and to evaluate its link with socio demographic, biochemical
and clinical factors.
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
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
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.
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
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.
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.
Metabolic syndrome among Sri Lankan adults: prevalence,
patterns and correlates
Prasad Katulanda et al;
3. Diabetology and Metabolic