Epidemiology of metabolic syndrome in Asia

Metabolic syndrome (MS) is a rising disease entity characterized by a clustering of metabolic conditions. Although prevalence of obesity as defined by the World Health Organization (WHO) is relatively low in Asia compared to western countries, metabolic syndrome is growing into a significant public health problem. Comparative studies indicate that metabolic responses to obesity may be greater in South and East Asians than their western counterparts at given Body Mass Indexes (BMIs). Higher percentage body fat in Asians at given BMIs and over-responsiveness to obesity may in part explain the phenomenon for which the underlying causes are not clear. Furthermore, aborigines may be at an even greater MS risk. The metabolic syndrome definition itself as well as whether it should be defined are controversial. The National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) gives equal weight to each component disorder, while the International Diabetes Federation (IDF) takes central obesity as a pre-requisite. Both criteria adopt ethnic-specific cut-off points for waist circumference. Asian data favour the new NCEP-ATP III definition, as individuals that were selected through the NCEP criteria but disregarded by the IDF criteria had similar Framingham cardiovascular disease risk scores to those picked by both definitions. Prospective data show that the metabolic syndrome not only increases the risk of coronary artery disease but also cerebrovascular disease in Asians. Macronutrient composition and the quality of the diet are associated with the risk of metabolic syndrome. More research is needed to relate diet and metabolic syndrome in Asians.