title: Gender, socio-economic status and metabolic syndrome in middle-aged and old adults.
abstract: BACKGROUND
  Studies that addressed social and economic determinants of cardiovascular diseases, consistently showed an increase prevalence of the individual features of metabolic syndrome in the lower socio-economic strata. Thus, this study aimed to evaluate the association between social class and metabolic syndrome in a sample of urban middle-aged and old Portuguese adults.
  
  
  METHODS
  We evaluated 1962 subjects (1207 women and 755 men) aged 40 or more years. Marital status, education, occupation, menarche age and height distribution were used as socioeconomic indicators. Metabolic syndrome was defined according to the ATP III, by the presence of at least three of the following characteristics: waist circumference > 102 cm in men and > 88 cm in women; triglycerides > or = 150 mg/dl; HDL cholesterol < 40 mg/dl in men and < 50 mg/dl in women; blood pressure > or = 130/85 mm Hg; and fasting glucose > or = 110 mg/dl. Proportions were compared using the chi square test or Fisher's exact test. Odds ratios (OR) and 95% confidence intervals (95% CI) were computed using unconditional logistic regression to estimate the magnitude of the associations.
  
  
  RESULTS
  Metabolic syndrome was significantly more frequent in females (24.9 vs. 17.4, p < 0.001). In females, the odds favoring metabolic syndrome significantly increased with age and in unfavorable social class as described by occupation, and decreased with education level. In males, metabolic syndrome was significantly more frequent in the 60-69 years age class (OR = 1.82; 95%CI: 1.02-3.26) when compared to those in the 40-49 years age class. Concerning other socioeconomic indicators no significant associations were found.
  
  
  CONCLUSIONS
  This study showed that gender influenced the association of socio-economic status indicators with metabolic syndrome. Females in lower social classes, as defined by education and occupational classification, more frequently presented metabolic syndrome, no such association was found in males.
authors.affiliation: Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal. acsantos@med.up.pt
authors.forename: Ana C
authors.initials: AC
authors.lastname: Santos
authors.forename: Shah
authors.initials: S
authors.lastname: Ebrahim
authors.forename: Henrique
authors.initials: H
authors.lastname: Barros
mesh_terms: D017677:Age Distribution; D000368:Aged; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012737:Sex Factors; D012923:Social Class