Available online 15 March 2024

Author links open overlay panel, , , ABSTRACTPurpose

Although Premetabolic syndrome (PeMetSyn) is a precursor for metabolic syndrome (MetSyn), its prevalence and trends are unknown. This study examined the prevalence and trends in PreMetSyn and its association with sociodemographic risk factors in American adults.

Methods

The 1999-2000 to 2017-2020 United States National Health and Nutritional Health Surveys (NHANES) data were used. PreMetSyn was defined as co-occurrence two cardiometabolic risk factors consisting of abdominal obesity, elevated triglycerides, reduced HDL-C, elevated blood pressure, and fasting plasma glucose. We calculated sex-specific overall prevalence of PreMetSyn and by race/ethnicity, age, education, poverty, and body mass index (BMI) categories. Sex-specific logistic regression models were used to test the association between sociodemographic risk factors and PreMetSyn.

Results

From 1999 -2000 to 2017-2020, the age-adjusted overall prevalence of PreMetSyn increased by 155.4% (from 9.2% to 23.5%) in men and by 131.3% (from 11.2% to 25.9%) in women. Increases in prevalence of PreMetSyn were observed by race/ethnicity, age, education, poverty and BMI levels in men and women from 1999-2000 to 2017-2020. Survey cycle, race/ethnicity, age, education, poverty-income ratio, and BMI were independently associated with greater odds of PreMetSyn in males and females. During this period, the co-occurrence of abdominal obesity and elevated blood pressure was the most common comorbidity and increased from 20.6% to 30.8% in men and from 27.8% to 36.1% in women.

Conclusions

This nationally representative study indicates a rapid increase from 1999-2000 to 2017-2020 in the proportion of American adults who meet the criteria for PreMetSyn. Early identification of subjects with PreMetSyn in the U.S. is a public health priority for initiating effective strategies to prevent the development of MetSyn and its associated chronic diseases.

Section snippetsINTRODUCTION

Introduced as syndrome X in 1988 by Reaven [1], metabolic syndrome (MetSyn) is an assemblage of cardiometabolic risk factors consisting of central adiposity, elevated blood pressure, dyslipidemia (elevated triglycerides and low levels of high-density lipoprotein cholesterol), and hyperglycemia [2], [3]. MetSyn is associated with a doubling of cardiovascular diseases [4], increased risk of incident type 2 diabetes [5], and all-cause mortality [6]. The U.S. adult age-adjusted prevalence of the

Study Design

The US National Center for Health Statistics (NCHS) provided the NHANES data used in this study. A detailed description of the NHANES, including survey methods, is widely published [13], [14], and is available on the NCHS website [15]. Briefly, NHANES is a cross-sectional survey that started in the early 1960s to assess American health and nutritional conditions. It became a continuous program in 1999 with data collected on a two-year cycle. NHANES uses a stratified, multistage probability

Basic Characteristics of Study Population

The characteristics of the eligible men and women in this study are shown in Table 1, Table 2, respectively. A total of 33272 men and 35762 women aged 18–80 years were eligible for this study. The 2017-2020 male and female participants were older and had higher values of BMI, DBP, and SBP compared to participants in other survey periods (P<.01). Among males, mean values of BMI, DBP, SBP, FBG, and HDL-C were higher in 2017-2020 than the 1999-2000 study periods and increased by 6.6%, 4.2%, 1.6%,

DISCUSSION

PreMetSyn is an often ignored asymptomatic and a leading risk factor for developing MetSyn and is possibly a lifetime burden of cardiometabolic diseases. The importance of PreMetSyn relates to the fact that if untreated, it progresses to type 2 diabetes [18], and overt MetSyn [19] which is increasing globally and most noticeably in developed countries [20], [21], [22], [23]. Hence, determining the prevalence of PreMetSyn is critical for targeted public health intervention in preventing MetSyn

CONCLUSION

This nationally representative study indicates a rapid increase from 1999-2000 to 2017-2020 in the proportion of American adults who meet the criteria for PreMetSyn. The much higher prevalence of PreMetSyn in 2017-2020 than in 1999–2000 suggests that PreMetSyn is a growing problem that has ominous public health implications in the entire U.S. population, including subjects with normal weight. Therefore, timely and continuous identification of subjects with PreMetSyn in the U.S. is a public

FUNDING

This work was not supported by funding.

CRediT authorship contribution statement

Hodan Abdi: Writing – original draft, Software, Methodology, Formal analysis, Data curation. Bryan O Okosun: Writing – original draft, Methodology, Formal analysis, Data curation. Oluwatomi Amuda: Writing – original draft, Software, Methodology, Formal analysis, Data curation. Ike S Okosun: Writing – review & editing, Writing – original draft, Supervision, Project administration, Methodology, Data curation, Conceptualization.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

ACKNOWLEDGMENTS

The co-authors thank the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC) for the NHANES data.

DECLARATION OF COMPETING INTEREST

The authors have no financial interests/personal relationships which may be considered as potential competing interests.

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