Abstract

ASCHNER MONTOYA, PABLO. METABOLIC SYNDROME IN A RURAL AND AN URBAN POPULATION IN THE COLOMBIAN REGION OF THE ANDES. rev.fac.med [online]. 2007, vol.15, n.2, pp.154-162. ISSN 0121-5256.

The metabolic syndrome (MetS) has gone through a series of changes in its definitions, being the most important those proposed by the World Health Organization (WHO), the third Cholesterol Adult Treatment Panel (ATPIII) and the International Diabetes Federation (IDF). Although its components are still associated with insulin resistance, abdominal obesity has become the main common factor, accepting that the cutoffs to define it are ethnic specific. The prevalence studies of MetS have shown a great variability in their results which depend on the ethnic group, the geographic and sociocultural environment as well as the definition used. The main objective of this study was to evaluate the just mentioned factors by collecting data from an urban population in the southern sector of Bogota (UP) and from a nearby rural population (RP). Two cross-sectional surveys were done with cluster sampling in all the adults aged 30 years and over, one in each population. Additional to the anthropometric measurements and recording of blood pressure, blood samples were collected at 2 hours post-glucose load to measure blood glucose, lipids and insulin. The prevalence of the MetS was compared in both population by the WHO modified definition. In the urban population the latter was also compared with the ATPIII and the IDF definitions. In the RP 2.8% of men and 17.9% of women had MetS by the WHO definition. In the UP the prevalence was14.1% for men and 26% for women. By the ATPIII definition, the frequency of the MetS in the UP increased to 25.3% in men, however remained unchanged in women (25.4%). Finally, by the IDF definition, the frequency increased to 34.8% en men and to 35.8% in women. These results demonstrate that the prevalence of the MetS has been increasing as the criteria for its diagnosis have been changing and abdominal obesity has become more relevant. In urban men, the MetS is twice as frequent by the IDF definition when compared to the WHO definition. No difference was found in the prevalence of the MetS between urban and rural women in this study. In contrast, frequency of MetS was four times lower in rural when compared with urban men. This group also had the lowest prevalence of obesity, IGT, diabetes and insulin resistance. It is very probable that physical activity and/or physical fitness may have a strong influence in these remarkable differences found in the male population. In Colombia, the population is becoming urbanized and around 7 million people are changing their lifestyle and increasing the risk of MetS and its consequences. They constitute a very important target for prevention of diabetes and cardiovascular disease, particularly in the male population.

Keywords : Metabolic Syndrome X; epidemiology; obesity; risk factors.