The prevalence of the metabolic syndrome in Greece: the MetS-Greece Multicentre Study

Background: The Third Report (ATP III) of the National Cholesterol Education Program Expert Panel (NCEP) highlighted the importance of identifying and treating patients with the metabolic syndrome (MetS) to prevent cardiovascular disease (CVD) and progression to diabetes mellitus. Limited information is available about the prevalence of MetS, as defined by the NCEP ATP 111, in Europe, especially in Greece. Objective: To estimate the prevalence of the MetS in Greece, The MetS-Greece Study. Design and participants: A cross-sectional analysis of a representative sample of Greek adults (4153 participants older than 18 years). One group consisting of military personnel (n = 300) and another one from a Greek Muslim Community (n = 300) were used for comparison. In all, 4753 subjects were included in the final analysis. Results: All subjects from the general population were Caucasian men (49%) and women (51%), living in urban (n = 2243, 54%), semi-urban (n = 1038, 25%) and rural (n = 872, 21%) areas. The age-standardized prevalence of the MetS was 23.6% [95% confidence interval (Cl): 22.4-25.1%]. This was similar in men (24.2%, 95% Cl: 22.3-25.2%) and women (22.8%, 95% Cl: 21.4-25.0%) (p = 0.3). The prevalence increased with age in both sexes, 4.8% among participants aged 19-29 years and 43% for participants over 70 years old (p for trend < 0.0001). There was a 14.7-fold increase in odds ratio for having MetS in the age group > 70 years old compared with that of 19-29 years old (p < 0.0001) Most of those with MetS had three components of the syndrome (61%), 29% had four and 10% had all five components. Abdominal obesity (82%) and arterial hypertension (78%) were the most common abnormalities in both sexes. The Greek Muslim Community, on a high-saturated fat diet, had the highest prevalence of the MetS (35.2%, 95% Cl: 30.4-40.3%), and the military group, with a high physical activity level and a diet 'close' to Mediterranean, had the lowest (9.4%, 95% Cl: 6.2-13.1%). According to the 2001 Census, about 2.3 million Greeks may have the MetS. Conclusions: These results show that the MetS is highly prevalent in the Greek adult population. This may have major implications for the incidence of CVD. Promoting healthy diets, low caloric intake and physical activity must be urgently undertaken.