Metabolic syndrome in Saudi Arabia.
OBJECTIVE
Metabolic syndrome (MS) is a well-established risk factor for the development of coronary artery disease (CAD). We designed this study to obtain the prevalence of MS and each of its components in Saudi Arabia. This study is part of Coronary Artery Disease in Saudi Study (CADISS).


METHODS
We conducted this community-based national epidemiological health survey by examining Saudi subjects in the age group of 30-70 years of selected households over a 5-year period between 1995 and 2000 in Saudi Arabia. We interviewed all subjects, examined and took measurements of their blood pressure, weight, height, waist circumference, as well as fasting samples of plasma glucose, triglycerides, and high-density lipoprotein (HDL) cholesterol. We obtained the prevalence of MS based on the presence of at least 3 of the following: abdominal obesity (waist circumference > 102 cm (40 inch) in male and > 88 cm (35 inch) in female), triglycerides > or = 150 mg/dl (1.69 mmol/L), HDL cholesterol < 40 mg/dl (1.03 mmol/L) in male and < 50 mg/dl (1.29 mmol/L) in female, blood pressure > or = 130/85 mm Hg, fasting glucose > or = 110 mg/dl (6.1 mmol/L) as defined by the Adult Treatment Panel (ATP) III in 2001.


RESULTS
We included 17,293 subjects in this survey during the study period. The overall age-adjusted prevalence of MS in Saudi Arabia obtained from this study is 39.3%. Age adjusted prevalence in males is 37.2% and crude prevalence is 40.9% (95% confidence interval [CI] 39.8-42), while females have a higher prevalence of 42% and crude prevalence of 41.9% (95% CI 40.9-42.9). Saudi subjects from urban areas have significantly higher prevalence of 44.1% (95% CI 43.2-45) compared to those living in rural areas of 35.6% (95% CI 34.3-36.7) (p<0.0001). Low HDL affects 81.8% of females and 74.8% of males with MS leading all other factors, and it continued to be consistent in all different age groups. Metabolic syndrome is a risk factor for CAD, as the prevalence of CAD was higher among patients with MS (6.7%) compared to subjects without MS (4.6%) (p<0.0001).


CONCLUSIONS
The prevalence of MS is high in Saudi Arabia. Low HDL cholesterol plays a major role in the contribution to the MS in Saudi Arabia. Therefore, we recommend routine assessment for the components of MS in patients with CAD, furthermore, we encourage aggressive management of the MS for primary prevention of CAD, particularly, measures to increase HDL cholesterol.
Al-Nozha
Mansour
M
Department of Medicine, College of Medicine, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia. malnozha@hotmail.com
Al-Khadra
Akram
A
Arafah
Mohammed R
MR
Al-Maatouq
Mohammed A
MA
Khalil
Mohamed Z
MZ
Khan
Nazeer B
NB
Al-Mazrou
Yaqoub Y
YY
Al-Marzouki
Khalid
K
Al-Harthi
Saad S
SS
Abdullah
Moheeb
M
Al-Shahid
Maie S
MS
Al-Mobeireek
Abdulellah
A
Nouh
Mohmmed S
MS
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001795:Blood Pressure Determination; D001835:Body Weight; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011336:Probability; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D012720:Severity of Illness Index; D017678:Sex Distribution