title: The metabolic syndrome among postmenopausal women in rural Canton: prevalence, associated factors, and the optimal obesity and atherogenic indices.
abstract: OBJECTIVE
  This research aimed to (i) determine the prevalence of metabolic syndrome (MetS) and its components; (ii) assess factors associated with MetS, and (iii) define optimal ethnic-specific cutoffs of obesity- and atherogenic-based markers to predict MetS among postmenopausal women in rural Canton.
  
  
  RESULTS
  The Rural Canton Diabetes and Metabolic Disorders Study, a population based cross-sectional study, was conducted during 2011-2012 in Canton. In person interviews, blood glucose and lipid measurements were completed for 4,706 postmenopausal women who did not receive hormone replacement therapy. MetS was diagnosed using criteria of the Joint-Interim-Statement (JIS), the International-Diabetes-Federation (IDF) and the Modified-Third-Adult-Treatment-Panel (M-ATPIII). Age-standardized prevalence of MetS was 38.4%, 28.8%, and 37.1% according to JIS, IDF, and M-ATPIII criteria, respectively. Excellent agreement was observed between three definitions (κ ≥ 0.79), in particular between JIS and ATPIII (κ = 0.98, 95%CI: 0.97-0.98). Factors positively associated with MetS were living in Southern Canton, personal income, current smoking, higher BMI, and family history of cardiovascular disease. However, regular leisure-time physical activity can have protective effects. The optimal cutoff values for waist-circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio(WHtR), BMI, HDL-cholesterol to total cholesterol ratio (HDL/TC), HDL-cholesterol to LDL-cholesterol ratio (HDL/LDL), and triglyceride to HDL-cholesterol ratio (TG/HDL) that predicted the presence of MetS were 79.5 cm, 0.86, 0.53, 22.47 kg/m(2), 0.33, 0.68, and 0.88, respectively.
  
  
  CONCLUSIONS
  This study highlights the importance of MetS among postmenopausal women in rural Canton. Our findings contribute to help selecting Cantonese-specific markers to predict MetS and support the need to establish educational program for promoting healthy-lifestyles among this population.
authors.affiliation: School of Biotechnology, Southern Medical University, Guangzhou, Guangdong Province, People's Republic of China ; Department of Primary Public Health, Canton Center for Disease Control and Prevention, Canton, Guangdong Province, People's Republic of China.
authors.forename: Huiying
authors.initials: H
authors.lastname: Liang
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.forename: Qiaozhu
authors.initials: Q
authors.lastname: Chen
authors.forename: Yulin
authors.initials: Y
authors.lastname: Wang
authors.forename: Xueji
authors.initials: X
authors.lastname: Wu
authors.forename: Yaohui
authors.initials: Y
authors.lastname: Li
authors.forename: Bingying
authors.initials: B
authors.lastname: Pan
authors.forename: Huazhang
authors.initials: H
authors.lastname: Liu
authors.forename: Ming
authors.initials: M
authors.lastname: Li
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005843:Geography; D006801:Humans; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D017698:Postmenopause; D015995:Prevalence; D012372:ROC Curve; D012307:Risk Factors; D012424:Rural Population
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