Distribution and Correlates of the Metabolic Syndrome in Adults Living in the San Juan Metropolitan Area of Puerto Rico

Abstract

Objective: This study evaluated correlates of the metabolic syndrome among adults living in Puerto Rico, a Hispanic subpopulation disproportionately affected by diabetes. Methods: A probability cluster design was used to select a sample of households of the San Juan Metropolitan Area in Puerto Rico. A total of 858 persons aged 21–79 years completed a face-to-face interview, blood pressure and anthropometric measurements, blood sampling and spot urine. Logistic regression was employed to assess correlates of the metabolic syndrome. Results: Of 368 (42.9%) of adults who met the criteria for metabolic syndrome, elevated fasting glucose (49.8%), abdominal obesity (48.6%), and reduced HDL cholesterol (45.8%) were the most prevalent diagnostic criteria. In a multivariable logistic model that simultaneously adjusted for sociodemographic characteristics and health behaviors, older age, high school educational attainment or less, no alcohol intake, and lack of moderate-to-vigorous physical activity remained significantly (p < 0.05) associated to the metabolic syndrome. However, the associations for male gender, some college education, and current smoking ≥20 cigarettes/day had borderline significance. Further controlling for inflammatory markers slightly attenuated the strength of most of these associations but remained significantly (p < 0.05) associated to the metabolic syndrome with only a few exceptions. Middle and upper tertiles of hs-CRP, fibrinogen, and PAI-1 and an elevated albumin-to-creatinine ratio were also associated (p < 0.05) with the metabolic syndrome. Conclusion: Enhancing public education regarding modifiable risk factors for the metabolic syndrome and providing optimal medical management of individual metabolic disturbances among those at risk through preventive lifestyle changes should be placed as a public health priority for Puerto Rico.