Prevalence, combinations and associations of components of MetS among adults aged 40 years and above from rural Kerala: a cross-sectional study

Thiyagarajan Palanichamy, Vasantha Elango


Background: Metabolic syndrome (MetS) is a growing public health concern worldwide. A nation-wide diabetes screening campaign by the union health ministry found rural areas of selected district of Kerala had16% prevalence of lifestyle diseases. One of the objectives of WHO developed action plan for global implementation of strategies in prevention and control of non-communicable diseases (NCDs) advocates identifying MetS, a simple clinical tool, for predicting diabetes mellitus and cardiovascular diseases among population. The study aimed to estimate the prevalence of metabolic syndrome and its components among the adults aged 40 and above from rural Kerala and to determine the association with socio-demographic characteristics like co-variables of the study population.

Methods: A cross-sectional study conducted among adult subjects aged 40 and above from rural field practice areas visiting RHTC. Socio-demographic profile, personal habits and history on NCDs recorded. Blood pressure and abdominal circumference measured. Fasting plasma glucose (FPG), triglyceride (TG), and high-density lipoprotein (HDL) levels were estimated. Modified NCEP-ATP III (SAS), 2009 criteria was used to diagnose MetS. Study variables were analysed for associations and comparison of means with appropriate statistical methods.

Results: The prevalence of metabolic syndrome (MetS) was 29.3%. 57.9% elevated FPG, 37% Triglyceridemia, 24% sub-optimal HDL, 38.3% abdominal obesity, 38.3% elevated BP, 52% insulin resistance were recorded. Among MetS subjects 50% were in 50-59 years age group and MetS had statistically significant association with age (p value 0.005).

Conclusions: Moderate prevalence of metabolic syndrome among rural subjects needs strengthening health education and screening services on NCDs.



Association, Component combinations, MetS, Rural population

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Sande MA, Walraven GE, Milligan PJ, Banya WA, Ceesay SM, Nyan OA, et al. Family history: an opportunity for early interventions and improved control of hypertension, obesity and diabetes. Bulletin. WHO. 2001;79(4):321-8.

International Diabetes Federation. The IDF Consensus Worldwide Definition of the Metabolic Syndrome. International Diabetes Federation; 2006. Available at Meta_def_ final.pdf. Accessed on 12 July 2020.

Pandit K, Goswami S, Ghosh S, Mukhopadhyay P, Chowdhury S. Metabolic syndrome in South Asians. Indian J Endocr Metab. 2012;16(1):44-55.

Report of National Family Health Survey-3 (NFHS-3). 2007. Available at NFHS/ nfhs3. shtml. Accessed on 12 July 2020.

Kumar VG. High prevalence of type2 diabetes mellitus and other metabolic disorders in a rural village in central Kerala. J Assoc Physicians India. 2009;57:563-7.

Enas EA, Yusuf S, Mehta JL. Prevalence of coronary artery disease in Asian Indians. Am J Cardiol. 1992;70(9):945-9.

Reaven GM. Insulin resistance, compensatory hyperinsulinaemia and coronary heart disease: syndrome X revisied. In: Jafferson LS, Cherrington AD, eds. Handbook of Physiology. New York, NY. Oxford University Press. 2001:1169-1197

Gaziano JM, Hennekens CH, O’ Donnell. Fasting triglycerides, high-density lipoprotein, and risk of myocardial infarction. J Am Heart Association. 2001;96:2520-5.

Pradeep A, Thomas L. A study on clinical profile of metabolic syndrome and its impact on myocardial infarction at a tertiary care Hospital in Kerala. Int J Pharm Sci Res. 2018;9(9):3919-25.

Jose R, Manojan KK, Augustine P, Nujum ZT, Althaf A, Haran JC, et al. Prevalence of Type 2 Diabetes and Prediabetes in Neyyattinkara Taluk of South Kerala. Academic Med J India. 2013;1(1):43-9.

NHM-NPCDCS-National NCD cell Report. Nation-wide campaign for screening diabetes in rural areas by the Union health ministry. 2013. NHM-NPCDCS-National NCD cell Union health Ministry, Government of India. Available at: nhm. /index1.php?lan =1&level=2&sublinkid=1048&lid. Accessed on 12 July 2020.

Jacob AM, Anjana MS, Kaippallil JD. Some aspects of human population with special reference to certain diseases in Kaviyoor panchayat, Thiruvalla taluk, Pathanamthitta district, Kerala. J Academia. 2013;65:78-85.

2008-2013 Action plan for the Prevention and Control of Non-communicable Diseases in the WHO regions. WHO Report 2009. Available at 9789241597418/en/ Accessed on 12 July 2020.

Mohan V, Pradeepa S, Surendar J, Indulekha K, Chella S, Anjana RM. Prevalence of metabolic syndrome and its association with coronary artery disease among an urban elderly south Indian population (CURES 145). J Assoc Physicians India. 2016;64:20-5.

Banerjee R, Dasgupta A, Naskar NN, Kundu PK, Pan T, Burman J. A study on the prevalence of metabolic syndrome and its components among adults aged 18-49 years in an urban area of West Bengal. Indian J Community Med. 2019;7:93-9.

Roshni M. Metabolic syndrome and the frequency of occurrence of its components in urban South Indian population. British J Med Res. 2014;4(29):4855-67.

Rajendran S, Manju M, Premkumar A, Mishra S. Prevalence of metabolic syndrome and its components among young adults at a tertiary care hospital in Puducherry. Med Pulse Int J Biochem. 2018;8(1):1-6.

Thankappan KR, Bela S, Prashant M. Risk factor profile for chronic non-communicable diseases: results of a community-based study in Kerala, India. Indian J Med Res. 2010;131:53-63

Selvaraj I, Gopalakrishnan S, Lograj M. Prevalence of metabolic syndrome among rural women in a primary health centre area in Tamil Nadu. Indian J Public Health. 2012;56(4):314-7.

Harikrishnan S, Sarma S, Sanjay G, Jeemon P, Krishnan MN, Venugopal K, et al. Prevalence of metabolic syndrome and its risk factors in Kerala, South India: Analysis of a community based cross-sectional study. PLoS One. 2018;13:e0192372.

Srinivasan S. Metabolic syndrome in rural Kerala: a hospital based study. Int J Adv Med. 2016;3(4):898-904.

NCEP 5th report. 2002. Circulation 106. National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III).Final report (2009).

Tan CE, Ma S, Wai D, Chew SK, Tai ES. Can we apply the National Cholesterol Education Program Adult Treatment Panel definition of the metabolic syndrome to Asians? Diab Care. 2004;27:1182-6.