title: Metabolic syndrome and social deprivation: results of a French observational multicentre survey.
abstract: BACKGROUND
  Deprivation, a process that prevents people to assume their social responsibilities, is a main cause of inequalities in health. Metabolic syndrome has a growing prevalence in France.
  
  
  OBJECTIVE
  To assess the association between deprivation and the metabolic syndrome and to identify the most relevant waist circumference cut-off point.
  
  
  METHODS
  A cross-sectional multicentre study was carried out of data extracted from health examination centres of two French areas in 2008. The harmonized definition of the metabolic syndrome contained five criteria with two thresholds for waist circumference. Deprivation was calculated by the Evaluation of Deprivation and Inequalities in Health Examination Centres score (EPICES). Eligible patients were at least 16 years old. The methodology of time to event analysis was used on patients having two criteria to identify the most relevant waist circumference threshold, taking waist circumference as event and computing it as a continuous variable. The median corresponded to the waist circumference threshold for which half of the patients switched from two to three criteria and so metabolic syndrome.
  
  
  RESULTS
  Of the 32374 persons included in the study, 39.4% were socially deprived. The prevalence of the metabolic syndrome varied from 16.3% to 22.2% in the overall sample depending on the published waist circumference thresholds chosen. Deprivation was an independent factor associated with the metabolic syndrome. The cut-off point for waist circumference was between 95 and 99 cm for men and 88 and 97 cm for women.
  
  
  CONCLUSIONS
  Deprivation is associated with a higher prevalence of the metabolic syndrome. The most relevant threshold for waist circumference could be 94 cm for men and 88 cm for women.
authors.affiliation: Service de Santé Publique, Centre Hospitalo-Universitaire de Clermont-Ferrand, Clermont-Ferrand, France, Clermont Université, EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement), Université d'Auvergne, Clermont-Ferrand, France, mblanquet@chu-clermontferrand.fr.
authors.forename: Marie
authors.initials: M
authors.lastname: Blanquet
authors.affiliation: Service de Santé Publique, Centre Hospitalo-Universitaire de Clermont-Ferrand, Clermont-Ferrand, France, Clermont Université, EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement), Université d'Auvergne, Clermont-Ferrand, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Debost-Legrand
authors.affiliation: Service de Santé Publique, Centre Hospitalo-Universitaire de Clermont-Ferrand, Clermont-Ferrand, France, Clermont Université, EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement), Université d'Auvergne, Clermont-Ferrand, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Gerbaud
authors.affiliation: Santé, Prévention, Institut de Santé Bourgogne-Auvergne, Roanne, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: de La Celle
authors.affiliation: Centre d'examen de santé, Angoulême, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Brigand
authors.affiliation: Unité Mixte de Recherche 1019, Institut National de la Recherche Agronomique, Saint-Genès-Champanelle, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Mioche
authors.affiliation: Centre Technique d'Appui et de Formation des Centres d'Examens de Santé, Saint-Etienne, France and.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sass
authors.affiliation: Service de Santé Publique, Centre Hospitalo-Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Juliette
authors.initials: J
authors.lastname: Hazart
authors.affiliation: Laboratoire de Mathématiques - Unité Mixte de Recherche 6620, PERISCOPE Créations, Université Blaise Pascal Clermont-Ferrand II, Aubière, France.
authors.forename: Alhassane
authors.initials: A
authors.lastname: Aw
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D054624:Health Status Disparities; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology; D015995:Prevalence; D011320:Primary Health Care; D012923:Social Class; D035862:Vulnerable Populations; D055105:Waist Circumference
keywords: Community health centres; metabolic Syndrome X; primary health care; psychosocial deprivation; vulnerable populations; waist circumference.