title: Metabolic syndrome: an emerging public health problem in Iranian women: Isfahan Healthy Heart Program.
abstract: OBJECTIVE
  To determine the gender-specific prevalence of the metabolic syndrome (Met S) in a representative sample of Iranian adults, and to identify some possible related lifestyle factors.
  
  
  METHODS
  As the baseline survey of a community-based interventional program entitled Isfahan Healthy Heart Program, we performed this cross-sectional study on 12,514 adults (> or =19 years) living in urban and rural areas of 3 cities in Iran. We assessed the prevalence of the Met S (according to the ATP III criteria) as well as dietary intake (based on food frequency questionnaire) and physical activity habits of all of the participants. We also evaluated dietary intake at the micronutrient level by using a one-day food record in a sub-sample of 2000 participants.
  
  
  RESULTS
  The age-adjusted prevalence of Met S was 23.3%, with a higher prevalence in women compared to men (35.1% vs. 10.7%, P<0.05) and in urban residents compared to rural residents (24.2% vs. 19.5%, P<0.05). In all age groups and in both urban and rural areas, the Met S affected a significantly larger number of women than men. Among women, abdominal obesity (71.7%) was more prevalent followed by low HDL-C (60.9%) and hypertriglyceridemia (56.6%), whereas among men, the most frequent components were hypertriglyceridemia (49.1%) and low HDL-C (35.1%), respectively. Abdominal obesity was nearly six times as prevalent in women as in men (71.7% vs. 12%, P<0.05) and had a significant association with metabolic disorders even after adjustment for age, sex and the living area. In general, dietary intake had no effect on the prevalence of Met S. The prevalence of Met S in subjects with a sedentary lifestyle was significantly higher than in active subjects of both genders (25.6% vs. 14.4%, respectively, P<0.05).
  
  
  CONCLUSIONS
  The Met S is highly prevalent in the Iranian population, notably in women living in urban areas. Abdominal obesity and dyslipidemia characterize this syndrome. Implementing community-based strategies for lifestyle change is of great significance.
authors.affiliation: Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. crc@mui.ac.ir
authors.forename: Nizal
authors.initials: N
authors.lastname: Sarrafzadegan
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
authors.forename: Abdulmehdi
authors.initials: A
authors.lastname: Baghaei
authors.forename: Gholam
authors.initials: G
authors.lastname: Hussein Sadri
authors.forename: Hossein
authors.initials: H
authors.lastname: Malekafzali
authors.forename: Noushin
authors.initials: N
authors.lastname: Mohammadifard
authors.forename: Katayoun
authors.initials: K
authors.lastname: Rabiei
authors.forename: Ahmad
authors.initials: A
authors.lastname: Bahonar
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Sadeghi
authors.forename: Jenniffer
authors.initials: J
authors.lastname: O'Laughlin
mesh_terms: D050153:Abdominal Fat / Q000378:metabolism; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D011634:Public Health / Q000639:trends*; D012423:Rural Health / Q000639:trends; D012737:Sex Factors; D014504:Urban Health / Q000639:trends