Prevalence and Associations of Metabolic Syndrome in an Urban High Diabetes Risk Population in a Low/Middle-Income Country

Asma Ahmed, Jaweed Akhter, Romaina Iqbal, Abdul Jabbar, Minaz Mawani, Safia Awan, Zainab Samad, Preet Ayoub Shaikh, Muammad Salik, Jaakko Tuomilehto

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Background: We aimed to assess the burden of metabolic syndrome (MetS), and evaluate the phenotypic variation of MetS in a population at high risk for diabetes in urban Karachi, Pakistan. Methods: This study was embedded in a lifestyle intervention trial for the prevention of type 2 diabetes mellitus. The study population comprised participants who belonged to urban households in Karachi, Pakistan. Results: Among 15,590 individuals who were screened through diabetes risk score (DRS), 3945 individuals met the criteria for a high DRS (≥60). After excluding 1780 participants due to refusals and ineligibility, 2165 were enrolled, a total of 1188 subjects (54.9%) met the International Diabetes Federation criteria for MetS, and a total of 1199 subjects (55.4%) participants met the US National Cholesterol Education Program. Raised serum triglycerides (TGs) and low high-density lipoprotein (HDL) cholesterol were significantly associated with MetS. On multivariate logistic regression, higher body mass index levels (obese category: Odds ratio [OR] = 2.14, 95% confidence interval [CI] 1.56-2.95), age >44 years (OR = 2.64, 95% CI 1.93-3.60), and family history of diabetes in both parents (OR = 1.71, 95% CI 1.15-2.54) were found to be independently associated with MetS, whereas higher education (OR = 0.78, 95% CI 0.57-1.06) and physical activity levels (OR = 0.74, 95% CI 0.57-0.96) had lower odds of MetS. Conclusion: One in two individuals with a high DRS in an urban low/middle-income country setting met the criteria for MetS. Patients with atherogenic dyslipidemia defined as low HDL and high TGs represent unique subphenotypes of MetS in this population.

Original languageEnglish
Pages (from-to)234-242
Number of pages9
JournalMetabolic Syndrome and Related Disorders
Issue number5
Publication statusPublished - 1 Jun 2020


  • body mass index
  • diabetes risk score
  • dyslipidemia
  • hypertension
  • metabolic syndrome
  • waist circumference


Dive into the research topics of 'Prevalence and Associations of Metabolic Syndrome in an Urban High Diabetes Risk Population in a Low/Middle-Income Country'. Together they form a unique fingerprint.

Cite this