Education eclipses ethnicity in predicting the development of the metabolic syndrome in different ethnic groups in midlife: the Study of Women's Health Across the Nation (SWAN).
OBJECTIVE
To determine the respective roles of socio-economic status (SES) and ethnicity in the risk of incident metabolic syndrome in middle-aged women.


METHODS
A total of 3302 pre- and peri-menopausal women, not receiving hormone therapy at baseline, took part in the Study of Women's Health Across the Nation, a multi-site, community-based, longitudinal study of the menopausal transition. The main outcome measures were to ascertain the prevalence of the metabolic syndrome and the incidence of the metabolic syndrome over 5 years of follow-up.


RESULTS
At baseline, the prevalence of the metabolic syndrome was 21% (n = 673). Among 2512 women without metabolic syndrome at baseline, 12.8% (n = 321) developed the metabolic syndrome during 5 years of follow-up. Both ethnicity and SES were significant univariate predictors of incident metabolic syndrome. In multivariate logistic regression models that included age at baseline, menopausal status and site, baseline smoking and alcohol consumption at follow-up visit 1, as well as baseline values of each of the components of the metabolic syndrome, only education was an independent predictor of incident metabolic syndrome.


CONCLUSIONS
Approximately 13% of peri-menopausal women developed the metabolic syndrome during the 5-year follow-up period. Education, but not ethnicity, was an independent predictor of incident metabolic syndrome risk.
Scuteri
A
A
UO Geriatria-Istituto Nazionale Ricovero e Cura per Anziani (INRCA), IRCCS, Rome, Italy. angeloelefante@interfree.it
Vuga
M
M
Najjar
S S
SS
Mehta
V
V
Everson-Rose
S A
SA
Sutton-Tyrrell
K
K
Matthews
K
K
Lakatta
E G
EG
D000328:Adult; D002318:Cardiovascular Diseases / Q000208:ethnology; D005260:Female; D006801:Humans; D008593:Menopause / Q000208:ethnology*; D024821:Metabolic Syndrome / Q000208:ethnology*; D008875:Middle Aged; D015995:Prevalence; D044469:Racial Groups / Q000208:ethnology*; D012923:Social Class; D014481:United States / Q000453:epidemiology; D016387:Women's Health / Q000208:ethnology*