Sex Differences in the Prevalence and Associated Factors of Metabolic Syndrome: A Cross-Sectional Study of University Employees in China

Sex may exhibit differences in the MetS prevalence in diverse populations, particularly within specific occupational groups. This study aimed to explore sex differences in the prevalence and determinants of metabolic syndrome (MetS) among university employees in China.

This cross-sectional study included the data from 2594 adults (1198 men and 1396 women) who underwent health examinations in 2024 in Chengdu, China. MetS was defined using modified National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria, with waist circumference thresholds adapted for Chinese adults (≥90 cm for men, ≥85 cm for women). Multiple imputation was employed to handle missing data for HbA1c and homocysteine. Multivariable logistic regression was used to assess the independent association between sex and MetS, along with subgroup analyses by age and body mass index (BMI).

The overall prevalence of MetS was 23.4%, significantly higher in men compared to women (31.9% vs. 16.1%, p<0.001). Men exhibited a higher prevalence of all MetS components except for low HDL-C. After adjusting for age, BMI, lifestyle factors, blood pressure, lipids, glucose, and uric acid, male sex remained an significant risk factor for MetS (adjusted odds ratio [aOR] = 2.13, 95% CI: 1.46-3.10). Significant interactions were observed between sex and age (p =0.030), between sex and BMI (p =0.006). The association between male sex and MetS was more pronounced in younger participants than the older, in those without obesity than those with obesity.

Male sex is a significant risk factor associated with MetS among Chinese university employees. The extent of this sex disparity is notably influenced by age and BMI status in terms of statistical interaction. These findings suggest developing sex-, age-, and weight-specific strategies for the prevention and management of MetS.