Metabolic syndrome and psychosocial deprivation. Data collected from a Paris suburb

The association between the metabolic syndrome (MetS) and socioeconomic deprivation has already been recognized. The aim of this study was to examine the relationship between MetS and psychosocial deprivation, and to determine whether or not this relationship is independent of gender, age and obesity.

The sample included 17074 subjects, aged 16-91 years, who attended the Health Examination Centre of the National Health Insurance Service at Bobigny (a northern suburb of Paris). Exclusion criteria were known diabetes and current lipid-lowering treatment. MetS was defined according to NCEP-ATP III criteria. Psychosocial deprivation was analyzed using the Evaluation of Deprivation and Inequalities by Health Examination Centres (EPICES) score, which includes 11 validated questions and ranges from zero to 100. Psychosocial deprivation was defined as a score greater than or equal to 40.

The sample included slightly more women (52.5%) than men, and 52.5% were considered to be deprived. These subjects were slightly older (41 vs 40.2 years, P<0.0001). Around half of the study population benefited from social help. MetS prevalence was higher in the deprived group (11.5% vs 9.4%; P<0.0001), and this was confirmed for every age group. Similarly, the prevalence of all MetS components, except for blood glucose, was significantly higher. The deprivation rate increased with the number of MetS criteria in the non-obese. In a multiple logistic regression, female gender (OR=1.50), age (OR>14 for those over 50 compared with those aged 16-19 years) and deprivation (OR=1.22) were independent predictors of MetS. Taking obese and non-obese populations separately, deprivation remained an independent predictor of MetS only in the non-obese (OR=1.30).

Psychosocial deprivation is an independent determinant of MetS in non-obese people, and elderly psychosocially deprived women, even if not obese, are at a particularly high risk of MetS. Educational efforts need to be developed to prevent MetS and its consequences in this population.