Metabolic syndrome among Caribbean-born persons living in the U.S. Virgin Islands.
OBJECTIVE
To determine the frequency of the metabolic syndrome (MS) among four subpopulations in the United States Virgin Islands and to estimate the risk for the MS that is associated with waist circumference cutpoints among overweight and obese individuals.


METHODS
In a study undertaken from 1995 to 1999, data on demographic characteristics, anthropometric measurements, blood pressure measurements, and a blood sample were obtained from a population-based cohort of 893 Caribbean-born persons from four population subgroups who were living on Saint Croix (the largest island of the U.S. Virgin Islands) and who did not have a history of diagnosed diabetes. The four subpopulations were: (1) Hispanic white, (2) Hispanic black, (3) non-Hispanic black born in the U.S. Virgin Islands, and (4) non-Hispanic black born elsewhere in the Caribbean. Fasting blood samples were analyzed for glucose, insulin, triglycerides, and high-density lipoprotein cholesterol (HDL-C). National Cholesterol Education Program Adult Treatment Panel III guidelines were used to identify the MS. Insulin resistance was estimated by the homeostasis model assessment (HOMA-IR) method.


RESULTS
The overall prevalence of the MS in the sample was 20.5% (95% confidence interval (CI) = 15.3%-25.7%). Persons who had classified themselves as both Hispanic and black had the highest frequency (27.8% (95% CI = 16.3%-39.3%)) of the MS and the highest HOMA-IR scores. After controlling for lifestyle factors and HOMA-IR, Hispanic ethnicity was independently associated with an increased risk of having the MS (odds ratio (OR) = 1.82, (95% CI = 1.07-3.07)), high triglycerides (OR = 3.66 (95% CI = 2.18-6.15)), and low HDL-C (OR = 1.60 (95% CI = 1.04-2.45)). A waist circumference of > 88 cm was associated with an increased risk of metabolic abnormalities among overweight and obese women.


CONCLUSIONS
The frequency of the MS among Caribbean-born persons in the U. S. Virgin Islands is comparable to the frequency of the MS among the general population on the mainland of the United States. Among Caribbean-born persons living in the U.S. Virgin Islands, those who are Hispanic blacks may have a greater risk of cardiovascular disease than do other groups.
Tull
Eugene S
ES
Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania, USA. drmirt@yahoo.com
Thurland
Anne
A
LaPorte
Ronald E
RE
D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D044383:Black People; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D004641:Emigration and Immigration; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012737:Sex Factors; D014280:Triglycerides / Q000097:blood; D014767:United States Virgin Islands / Q000453:epidemiology
D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides