title: Social class and metabolic syndrome in populations from Tunisia and Spain.
abstract: BACKGROUND
  There is an increasing prevalence of obesity and metabolic syndrome (MS) in developing countries. It has been shown the relationship between social class and MS in developed countries. The objective of our study was to compare the association of social class with the prevalence of MS in a developing country (Tunisia, region of Cap-Bon) and a developed one (Spain, Canary Islands).
  
  
  METHODS
  Cross-sectional study of 6729 Canarian and 393 Tunisian individuals. Social class was measured with the income, crowding and education (ICE) model, which includes family income, household crowding and education level. Logistic regression models adjusted by age estimated the risk by odds ratio (OR) and confidence interval (CI 95 %) of MS according to social class.
  
  
  RESULTS
  MS prevalence was higher in Tunisian (50 %) than in Canarian women (29 %; p = 0.002), with no significant differences between men. For Canarian women, being in the highest social class was a protective factor against MS (OR = 0.39; CI 95 % 0.29-0.53) and all its components. The Canarian population and the Tunisian women, showed a significant linear trend (p < 0.001) of MS to decrease when social class increased.
  
  
  CONCLUSIONS
  High social class is a protective factor from MS and its components within the Canarian population and the Tunisian women. Our results suggest that the socioeconomic transition in a developing country like Tunisia can improve the population health in a sex-specific manner.
authors.affiliation: Research Unit 'Integrated Physiology', Laboratory of Biochemistry-Human Nutrition, Faculty of Sciences of Bizerte, UR11ES33, Carthage University, Tunis, Tunisia.
authors.forename: Fadoua
authors.initials: F
authors.lastname: Gannar
authors.affiliation: Research Unit, Nuestra Señora de la Candelaria University Hospital, University of La Laguna, Santa Cruz de Tenerife, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cabrera de León
authors.affiliation: Research Unit, Nuestra Señora de la Candelaria University Hospital, University of La Laguna, Santa Cruz de Tenerife, Spain.
authors.forename: Buenaventura
authors.initials: B
authors.lastname: Brito Díaz
authors.affiliation: Research Unit, Nuestra Señora de la Candelaria University Hospital, University of La Laguna, Santa Cruz de Tenerife, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Del Cristo Rodríguez Pérez
authors.affiliation: Research Unit, Nuestra Señora de la Candelaria University Hospital, University of La Laguna, Santa Cruz de Tenerife, Spain.
authors.forename: Itahisa
authors.initials: I
authors.lastname: Marcelino Rodríguez
authors.affiliation: Internal Medicine Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia.
authors.forename: Fatma
authors.initials: F
authors.lastname: Ben Dahmen
authors.affiliation: Research Unit 'Integrated Physiology', Laboratory of Biochemistry-Human Nutrition, Faculty of Sciences of Bizerte, UR11ES33, Carthage University, Tunis, Tunisia.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Sakly
authors.affiliation: Research Unit 'Integrated Physiology', Laboratory of Biochemistry-Human Nutrition, Faculty of Sciences of Bizerte, UR11ES33, Carthage University, Tunis, Tunisia.
authors.forename: Nabil
authors.initials: N
authors.lastname: Attia
keywords: Islanders; Metabolic syndrome; Social class; Tunisian population