Epidemiology of metabolic syndrome in Tunisia. HSHS 5 study


Asma Daouas
Asma Ben Abdelaziz
Youssef Zanina
Faten Yahia
Donia Ben Hassine
Sarra Melki
Mohamed Khelil
Nabila Ben Rejeb
Asma Omezzine
Ali Bouslama
Ahmed Ben Abdelaziz


Objective: To measure the prevalence of metabolic syndrome and its components in the HSHS cohort (Hammam Sousse, Tunisia), in 2009,
and to identify its determining factors.

Methods: This was a descriptive epidemiological study of the “community based” type having focused on a random sample of people aged
20 and over. The metabolic syndrome was defined according to the criteria of the “International Diabetes Federation” (IDF 2005) and those of
the “National Cholesterol Education Program-Adult Treatment Panel III” (NCEP-ATP III, 2001).

Results: The study involved 1441 people including 960 women (66.6%). The age- and sex-adjusted prevalences of increased waist
circumference, blood pressure, blood sugar and triglycerides, and decreased HDL-cholesterol were respectively 63.2%, 95%CI[62.5-63.8];
47.7%, 95%CI[47.4-48.6]; 25.7%, 95%CI[25.1-26.2]; 11.9%, 95%CI[11.4-12.3] and 65,6%, 95%CI[65.0-66.2], according to IDF thresholds and
37.4%, 95%CI[36.3-37.6]; 45.7%, 95%CI[45.4-46.6]; 13.8%, 95%CI[13.4-14.2]; 8.4%, 95%CI[8.0-8.7] and 61.9%, 95%CI[61.2-62.5], according
to those of the NCEP-ATP III. The prevalence of metabolic syndrome adjusted for age and sex was 36.5% 95%CI[33.0%-38.9%] according
to the IDF definition and 23.0% 95%CI[20.4%-25.6%] according to that of NCEP-ATP III. The multivariate study by logistic regression made it
possible to retain three significant independent determining factors of the metabolic syndrome: age ≥40 years, low level of physical activity and
family history of diabetes mellitus with respectively adjusted ORs of 3.77 95%CI[2.70-5.27], 1.39 95%CI[1.01-1.89], 1.62 95%CI[1.21-2.15],
according to IDF and 5.87 95%CI[3.88 -8.88], 1.47 95%CI[1.07-2.01] and 1.45 95%CI[1.07-1.96], according to NCEP-ATP III .

Conclusion: With this high prevalence rate of the metabolic syndrome, the establishment of an action plan would be essential. This plan should be based on
the combination of the promotion of physical activity and screening for the components of the metabolic syndrome, particularly in subjects aged 40 or over,
with a family history of diabetes mellitus.