Metabolic syndrome in a multiethnic population in rural Hawaii

The National Cholesterol Education Program Adult Treatment Panel III diagnostic criteria for metabolic syndrome (MS) provide a standard for comparing various populations. Using these criteria, the Third National Health and Nutrition Examination Survey reported an overall US prevalence of 21.8%. With these same criteria, we estimated the prevalence of MS among a multiethnic population in rural Hawaii.

These data are from a cross-sectional survey from 1997-2000.

The survey was conducted in the rural community of North Kohala.

More than 1,450 adult residents from five ethnic categories were included: Caucasian, Japanese, Filipino, Hawaiian/part-Hawaiian, Other/mixed non-Hawaiian. Ethnic ancestry was determined by self-report. Ethnic differences were compared by using logistic regression.

Blood pressure, height, weight, and waist circumference, fasting and two-hour post-oral glucose challenge plasma was obtained for lipid and glucose determinations.

Overall prevalence was 33.4%. Prevalence was significantly higher among all ethnic groups when compared to Caucasians. Despite significant differences in the prevalence of overweight and abdominal obesity, the prevalence of MS was similar in all non-Caucasian ethnic groups. Filipinos had the highest adjusted odds for prevalent MS (prevalence OR=4.2; 95% CI=2.4-7.3).

Metabolic syndrome (MS) prevalence was high in Asian ethnic groups previously reported to have low cardiovascular disease (CVD) mortality. These findings suggest either a differential effect of CVD risk factors on mortality among some ethnic groups, or more likely, that future mortality rates will increase among those ethnic groups that currently enjoy low mortality rates.