Prevalence and Factors Associated with Metabolic Syndrome among Brazilian Adult Population: National Health Survey - 2013

Ramires, Elyssia Karine Nunes Mendonça; Menezes, Risia Cristina Egito de; Longo-Silva, Giovana; Santos, Taíse Gama dos; Marinho, Patrícia de Menezes; Silveira, Jonas Augusto Cardoso da

doi:10.5935/abc.20180072

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Arquivos Brasileiros de Cardiologia

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Original Article, Epidemiology • Arq. Bras. Cardiol. 110 (5) • May 2018 • https://doi.org/10.5935/abc.20180072 copy

Prevalence and Factors Associated with Metabolic Syndrome among Brazilian Adult Population: National Health Survey - 2013

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background:

In Brazil, population-based researches analyzing prevalence and factors associated with metabolic syndrome (MS), a recognized predictor of cardiovascular diseases (CVD), and an important cause of disability and death in the country are scarce.

Objective:

To evaluate prevalence of MS and its associated factors in Brazilian population.

Methods:

Secondary analysis of the 2013 National Health Survey, a cross-sectional survey with national representativeness of Brazilian adult population (n = 59,402). MS was the outcome variable, defined from harmonization of cardiology international consensus as load ≥ 3 of the following components: self-reported diabetes and hypercholesterolemia, high blood pressure and high waist circumference. Analysis were stratified by sex and prevalence ratios, with their respective 99% confidence intervals (PR [CI 99%]) calculated by simple and multiple Poisson regression models.

Results:

MS prevalence was 8.9%, being significantly higher among women compared to men; in general, this pattern was maintained in relation to exposure variables studied. Additionally, less than 25% of population did not present any MS component. In final multiple models, sociodemographic, behavioral and comorbidity variables were associated with MS, however, while low schooling (1.46 [1.23-1.74], cerebrovascular accident (1.36 [1], 00] (1.28 [1.03-1.62]) were associated among women, chronic renal failure (1.85 [2.23-2.76]) was associated exclusively among men.

Conclusion:

We identified MS high prevalence in Brazilian population; on the other hand, factors associated with this condition were different depending on sex.

Keywords:
Cardiovascular Diseases / mortality; Metabolic Syndrome / epidemiology; Epidemiology; Adult; Public Health Surveillance; Health Surveys

Variables	MS^* *()** Generated considering the sample weight;
	Total^* *()** Generated considering the sample weight;		Male		Female
	N = 59.402^† (†) Number of individuals in the database;		N = 25.920^† (†) Number of individuals in the database;		N = 33.482^† (†) Number of individuals in the database;
	%^* *()** Generated considering the sample weight;	CI 99%	%^* *()** Generated considering the sample weight;	CI 99%	%^* *()** Generated considering the sample weight;	CI 99%
Age
18-59 years	81,8	80,9 - 82,5	83,3	82,4 - 84,1	80,4	79,6 - 81,1
≥ 60 years	18,2	17,4 - 19,0	16,7	15,9 - 17,5	19,6	18,8 - 20,9
Education
> 8 years	60,9	59,7 - 62,0	60,2	58,9 - 61,4	61,5	60,5 - 62,5
≤ 8 years	39,1	37,9 - 40,2	39,8	38,6 - 41,0	38,5	37,4 - 39,5
Skin color
White	47,4	46,4 - 48,5	46,8	45,7 - 47,9	48,1	47,0 - 49,1
Non-white ^§ (§) Yellow, indigenous, brown, black	52,5	51,5 - 53,6	53,2	52,1 - 54,3	51,9	50,9 - 53,0
Conjugal situation
Do not live with a partner	55,7	54,6 - 56,7	53,4	52,2 - 54,6	57,8	56,8 - 58,8
Live with a partner	44,3	43,2 - 45,3	46,6	45,4 - 47,8	42,2	41,2 - 43,2
Housing region
NE/N	34,0	33,3 - 34,7	34,2	33,4 - 35,1	33,8	32,9 - 34,6
SE/S/CW	66,0	65,3 - 66,7	65,8	64,9 - 66,6	66,2	65,4 - 67,0
Physical activity
Active	1,9	1,6 - 2,2	2,2	1,9 - 2,5	1,6	1,3 - 1,9
Inactive	98,1	97,8 - 98,4	97,8	97,5 - 98,1	98,4	98,0 - 98,6
Health self-perception
Very good/good	65,9	65,0 - 66,9	70,3	69,3 - 71,2	62,1	61,1 - 63,1
Regular - Very bad	34,1	33,0 - 34,9	29,7	28,8 - 30,7	37,9	36,9 - 38,9
Overweight
No	46,2	45,1 - 47,3	47,5	46,4 - 48,7	45,0	43,9 - 45,9
Yes	53,8	52,7 - 54,9	52,5	51,3 - 53,6	55,0	54,0 - 56,0
Another CVD ^‡ (‡) infarction, angina, heart failure or other.
No	95,8	95,3 - 96,2	96,1	95,6 - 96,5	95,5	95,1 - 95,9
Yes	4,2	3,8 - 4,7	3,9	3,5 - 4,4	4,5	4,1 - 4,9
Chronic renal failure
No	98,6	98,3 - 98,8	98,6	98,4 - 98,9	98,5	98,2 - 98,7
Yes	1,4	1,2 - 1,7	1,4	1,1 - 1,6	1,5	1,3 - 1,7
Stroke
No	98,5	98,2 - 98,7	98,4	98,1 - 98,6	98,5	98,3 - 98,7
Yes	1,5	1,3 - 1,8	1,6	1,4 - 1,9	1,5	1,3 - 1,7
Depression
No	92,3	91,7 - 92,9	96,1	95,6 - 96,5	88,9	88,3 - 89,6
Yes	7,7	7,1 - 8,2	3,9	3,5 - 4,4	11,1	10,4 - 11,7

Disease, burden and MS			Sex
	Total N = 59.402		Male N = 25.920		Female N = 33.482
	%^* *()** Generated considering the sample weight;	CI 99%	% ^* *()** Generated considering the sample weight;	CI 99%	% ^* *()** Generated considering the sample weight;	CI 99%
Diabetes	7,1	6,6 - 7,6	6,3	5,6 - 7,2	7,8	7,1 - 8,5
High BP	40,7	39,6 - 41,7	46,9	45,5 - 48,3	34,9	33,7 - 36,3
Hypercholesterolemia	14,7	14,0 - 15,5	11,9	10,9 - 13,1	16,9	16,0 - 17,9
High WC	65,2	64,4 - 65,9	55,6	54,0 - 57,1	73,9	72,7 - 75,0
Disease burden
0	23,8	22,9 - 24,7	28,0	26,7 - 29,4	19,9	18,8 - 21,1
1	38,1	37,2 - 39,0	34,8	33,5 - 36,2	41,0	39,8 - 42,3
2	29,2	28,3 - 30,1	29,7	28,4 - 31,0	28,7	27,6 - 29,9
3	7,5	7,1 - 8,1	6,5	5,8 - 7,3	8,5	7,8 - 9,3
4	1,4	0,9 - 1,2	1,0	0,7 - 1,3	1,8	1,5 - 2,2
MS Condition ^† (†) MS Condition, sum of disease burden ≥ 3 factors.	8,9	8,4 - 9,5	7,5	6,7 - 8,3	10,3	9,6 - 11,2

Variables	MS^* *()** Generated considering the sample weight;
	Total		Male		Female
	N = 59.402		N = 25.920		N = 33.482
	p (%)^* *()** Generated considering the sample weight;	CI 99%	p (%)^* *()** Generated considering the sample weight;	CI 99%	p (%)^* *()** Generated considering the sample weight;	CI 99%
Age
18-59 years	5,8	5,3 - 6,3	5,4	4,7 - 6,3	6,1	5,5 - 6,8
≥ 60 years	23,2	21,4 - 25,1	17,5	14,7 - 20,8	27,6	25,0 - 30,3
Education
> 8 years	6,3	5,7 - 6,9	6,8	5,8 - 7,8	5,8	5,1 - 6,6
≤ 8 years	13,1	12,1 - 14,2	8,4	7,1 - 9,9	17,6	15,9 - 19,3
Skin color
White	9,7	8,9 - 10,6	8,9	7,7 - 10,5	10,4	9,3 - 11,6
Non-white^† (†) Number of individuals in the database;	8,3	7,5 - 9,0	6,1	5,2 - 7,1	10,3	9,2 - 11,4
Conjugal situation
Do not live with a partner	6,9	6,4 - 7,6	4,6	3,8 - 5,6	8,9	8,1 - 9,8
Live with a partner	11,5	10,5 - 12,5	10,7	9,3 - 12,2	12,3	10,9 - 13,7
Housing region
NE/N	7,3	6,6 - 8,0	5,3	4,4 - 6,2	9,1	8,0 - 10,3
SE/S/CW	9,8	9,1 - 10,6	8,6	7,5 - 9,8	10,9	9,9 - 12,1
Physical activity
Active	1,8	0,7 - 4,9	2,5	0,7 - 8,6	1,0	0,3 - 3,4
Inactive	9,1	8,6 - 9,7	7,6	6,8 - 8,4	10,5	9,7 - 11,3
Health self-perception
Very good/good	4,8	4,3 - 5,3	4,5	3,8 - 5,4	5,0	4,4, 5,7
Regular - Very bad	17,1	15,9 - 18,3	14,4	12,5 - 16,5	19,0	17,4 - 20,7
Overweight
No	4,8	4,3 - 5,5	3,4	2,6 - 4,4	6,2	5,4 - 7,2
Yes	12,5	11,7 - 13,4	11,1	9,9 - 12,5	13,7	12,5 - 14,9
Another CVD ^‡ (‡) infarction, angina, heart failure or other.
No	8,3	7,7 - 8,8	6,9	6,1 - 7,7	9,5	8,8 - 10,3
Yes	24,9	20,9 - 29,4	21,8	15,9 - 29,2	27,3	22,2 - 33,2
Chronic renal failure
No	8,8	8,2 - 9,3	7,2	6,4 - 8,1	10,2	9,4 - 11,0
Yes	21,9	16,6 - 28,3	25,7	17,3 - 36,3	18,8	12,8 - 26,8
Stroke
No	8,7	8,1 - 9,2	7,2	6,4 - 8,1	10,0	9,3 - 10,8
Yes	27,0	20,6 - 34,5	22,7	14,2 - 34,2	31,4	22,6 - 41,7
Depression
No	8,3	7,7 - 8,8	7,1	6,3 - 7,8	9,4	8,6 - 10,3
Yes	17,1	14,6 - 19,9	15,6	10,7 - 22,3	17,6	14,7 - 20,9

Variables	Bivariate analysis		Model 1		Model 2		Model 3
Variables	PR	CI 99%	PR	CI 99%	PR	CI 99%	PR	CI 99%
Age
18-59 years	1		1		1		1
≥60 years	4,49	3,90- 5,18	3,44	2,95- 4,01	2,99	2,56- 3,48	3,20	2,76- 3,72
Education
>8 years	1		1		1		1
≤ 8 years	3,01	2,55- 3,55	1,98	1,67- 2,34	1,54	1,29- 1,83	1,46	1,23- 1,74
Conjugal situation
Do not live with a partner	1				1		1
Live with a partner	1,37	1,18- 1,58	1,38	1,21- 1,58	1,33	1,17- 1,52	1,27	1,11- 1,45
Housing region
NE/N	1		1		1		1
SE/S/CW	1,20	1,02- 1,41	1,18	1,01- 1,36	1,30	1,12- 1,52	1,18	1,02- 1,38
Skin color
White	1
Non-white^* *()** Yellow, indigenous, brown, black	0,98	0,84- 1,15
Physical activity
Active	1
Inactive	10,06	3,08- 32,84
Health self-perception
Very good/good	1				1		1
Regular - Very bad	3,76	3,23- 4,38			2,65	2,24- 3,14	2,35	1,99- 2,78
Stroke
No	1						1
Yes	3,13	2,29- 4,27					1,36	1,00- 1,86
Another CVD†
No	1						1
Yes	2,86	2,32- 3,51					1,29	1,03- 1,62
Overweight
No	1						1
Yes	2,19	1,85- 5,59					2,09	1,79- 2,42
Depression
No	1						1
Yes	1,86	1,54- 2,26					1,31	1,07- 1,59
Chronic renal failure
No	1
Yes	1,84	1,26- 2,69

Variables	Bivariate analysis		Model 1		Model 2		Model 3
Variables	PR	CI 99%	PR	CI 99%	PR	CI 99%	PR	CI 99%
Age
18-59 years	1		1		1		1
≥ 60 years	3,23	2,55- 4,08	2,74	2,17- 3,46	2,07	1,61- 2,67	2,60	2,04- 3,31
Education
> 8 years	1
≤ 8 years	1,24	0,99- 1,54
Conjugal situation
Do not live with a partner	1		1		1		1
Live with a partner	2,30	1,82- 2,92	1,81	1,43- 2,30	1,74	1,37- 2,20	1,48	1,17- 1,88
Housing region
NE/N	1		1		1		1
SE/S/CW	1,63	1,31- 2,02	1,49	1,20- 1,85	1,74	1,40- 2,14	1,57	1,28- 1,94
Skin color
White	1
Non-white†	0,67	0,54- 0,84
Physical activity
Active	1
Inactive	3,02	0,84- 10,90
Health self-perception
Very good/good	1				1		1
Regular - Very bad	3,17	2,51- 4-01			2,72	2,12- 3,50	2,59	2,01- 3,33
Stroke
No	1
Yes	3,15	1,99- 4,98
Another CVD^‡ (‡) infarction, angina, heart failure or other.
No	1
Yes	3,17	2,29- 4,39
Overweight
No	1						1
Yes	3,27	2,45- 4,37					3,58	2,73- 4,70
Depression
No	1						1
Yes	2,19	1,49- 3,23					1,41	0,98- 2,02
Chronic renal failure
No	1						1
Yes	3,57	2,41- 5,28					1,85	1,23- 2,76

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