Research Article

An urban–rural comparison of the prevalence of the metabolic syndrome in Eastern China

Xiaoping Weng^a1, Youxue Liu^a1, Jiemin Ma^a2, Wenjuan Wang^a3, Gonghuan Yang^a2 and Benjamin Caballero^a1 c1

^a1 Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA

^a2 Chinese Academy of Medical Science, Beijing, China

^a3 Chinese Center for Disease Control and Prevention, China

Abstract

Objective To assess the impact of urbanisation on the prevalence of the metabolic syndrome in Chinese adults.

Design As part of a community-based cross-sectional survey conducted in 2002, a sample from rural and urban populations in East China was obtained. The metabolic syndrome is defined by the National Cholesterol Education Program Adult Treatment Panel III criteria (ATP III) and the modified ATP III, which recommended a lower waist circumference cut-off for Asians.

Setting Field sites in Jiangxi and Anhui provinces and the Jing'an District of Shanghai, China.

Subjects A total of 529 non-pregnant, non-lactating urban and rural adults, aged 20–64 years without diagnosed diabetes.

Results Dwelling in urban areas was associated with higher dietary fat intake and slightly lower total energy intake, and with significantly lower occupational physical activity. Using the ATP III criteria, the prevalence of the metabolic syndrome was significantly higher for urban than rural men (12.7 vs. 1.7%, P < 0.001), and was similar between urban and rural women (10.1 vs. 9.7%, P = 0.17). These urban–rural differences were greatly enhanced when the modified ATP III criteria for the syndrome were used, for men (34.3 vs. 2.7%, P < 0.01) and women (24.1 vs. 11.4%, P = 0.07). The Asian waist circumference cut-offs (90 and 80 cm for men and women, respectively) had a better combination of sensitivity and specificity in identifying other metabolic disorders, which included high glucose, high blood pressure, high triglycerides and low high-density lipoprotein cholesterol, for this population.

Conclusion For the Chinese population, urban dwelling was associated with higher prevalence of the metabolic syndrome, especially in men.

(Received July 08 2005)

(Accepted April 03 2006)

Keywords

• Metabolic syndrome;
• Urban;
• Rural;
• Central obesity;
• China

Correspondence:

^c1 *Corresponding author: Email caballero@jhu.edu