title: Distribution and correlates of the metabolic syndrome in adults living in the San Juan Metropolitan Area of Puerto Rico.
abstract: OBJECTIVE
  This study evaluated correlates of the metabolic syndrome among adults living in Puerto Rico, a Hispanic subpopulation disproportionately affected by diabetes.
  
  
  METHODS
  A probability cluster design was used to select a sample of households of the San Juan Metropolitan Area in Puerto Rico. A total of 858 persons aged 21-79 years completed a face-to-face interview, blood pressure and anthropometric measurements, blood sampling and spot urine. Logistic regression was employed to assess correlates of the metabolic syndrome.
  
  
  RESULTS
  Of 368 (42.9%) of adults who met the criteria for metabolic syndrome, elevated fasting glucose (49.8%), abdominal obesity (48.6%), and reduced HDL cholesterol (45.8%) were the most prevalent diagnostic criteria. In a multivariable logistic model that simultaneously adjusted for sociodemographic characteristics and health behaviors, older age, high school educational attainment or less, no alcohol intake, and lack of moderate-to-vigorous physical activity remained significantly (p < 0.05) associated to the metabolic syndrome. However, the associations for male gender, some college education, and current smoking > or = 20 cigarettes/day had borderline significance. Further controlling for inflammatory markers slightly attenuated the strength of most of these associations but remained significantly (p < 0.05) associated to the metabolic syndrome with only a few exceptions. Middle and upper tertiles of hs-CRP, fibrinogen, and PLl-1 and an elevated albumin-to-creatinine ratio were also associated (p < 0.05) with the metabolic syndrome.
  
  
  CONCLUSIONS
  Enhancing public education regarding modifiable risk factors for the metabolic syndrome and providing optimal medical management of individual metabolic disturbances among those at risk through preventive lifestyle changes should be placed as a public health priority for Puerto Rico.
authors.affiliation: Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico. cynthia.perez1@upr.edu
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Pérez
authors.forename: Ana P
authors.initials: AP
authors.lastname: Ortiz
authors.forename: Manuel
authors.initials: M
authors.lastname: Guzmán
authors.forename: Erick
authors.initials: E
authors.lastname: Suárez
mesh_terms: D000328:Adult; D000368:Aged; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D011647:Puerto Rico / Q000453:epidemiology; D014504:Urban Health; D055815:Young Adult