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. 2013 Sep 9;8(9):e74121.
doi: 10.1371/journal.pone.0074121. eCollection 2013.

The Metabolic Syndrome Among Postmenopausal Women in Rural Canton: Prevalence, Associated Factors, and the Optimal Obesity and Atherogenic Indices

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The Metabolic Syndrome Among Postmenopausal Women in Rural Canton: Prevalence, Associated Factors, and the Optimal Obesity and Atherogenic Indices

Huiying Liang et al. PLoS One. .
Free PMC article


Objectives: This research aimed to (i) determine the prevalence of metabolic syndrome (MetS) and its components; (ii) assess factors associated with MetS, and (iii) define optimal ethnic-specific cutoffs of obesity- and atherogenic-based markers to predict MetS among postmenopausal women in rural Canton.

Methodology/principal findings: The Rural Canton Diabetes and Metabolic Disorders Study, a population based cross-sectional study, was conducted during 2011-2012 in Canton. In person interviews, blood glucose and lipid measurements were completed for 4,706 postmenopausal women who did not receive hormone replacement therapy. MetS was diagnosed using criteria of the Joint-Interim-Statement (JIS), the International-Diabetes-Federation (IDF) and the Modified-Third-Adult-Treatment-Panel (M-ATPIII). Age-standardized prevalence of MetS was 38.4%, 28.8%, and 37.1% according to JIS, IDF, and M-ATPIII criteria, respectively. Excellent agreement was observed between three definitions (κ ≥ 0.79), in particular between JIS and ATPIII (κ = 0.98, 95%CI: 0.97-0.98). Factors positively associated with MetS were living in Southern Canton, personal income, current smoking, higher BMI, and family history of cardiovascular disease. However, regular leisure-time physical activity can have protective effects. The optimal cutoff values for waist-circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio(WHtR), BMI, HDL-cholesterol to total cholesterol ratio (HDL/TC), HDL-cholesterol to LDL-cholesterol ratio (HDL/LDL), and triglyceride to HDL-cholesterol ratio (TG/HDL) that predicted the presence of MetS were 79.5 cm, 0.86, 0.53, 22.47 kg/m(2), 0.33, 0.68, and 0.88, respectively.

Conclusions: This study highlights the importance of MetS among postmenopausal women in rural Canton. Our findings contribute to help selecting Cantonese-specific markers to predict MetS and support the need to establish educational program for promoting healthy-lifestyles among this population.

Conflict of interest statement

Competing Interests: Ming Li is affiliated to Da An Gene Co., Ltd. However, there are no patents, products in development or marketed products to declare. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.


Figure 1
Figure 1. Districts and geographical areas (A) and flowchart (B) of the multistage stratified sampling procedure in the Rural Canton Diabetes and Metabolic Disorders Study (RCDMDS).
Figure 2
Figure 2. The ROC (receiver operating characteristic) curves for obesity (A) and atherogenic (B) indices to predict the presence of metabolic syndrome (MetS), as defined by the 2009 JIS criteria, among postmenopausal women in rural Canton.

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    1. Magliano DJ, Shaw JE, Zimmet PZ (2006) How to best define the metabolic syndrome. Ann Med 38: 34–41. - PubMed
    1. Park HS, Oh SW, Cho SI, Choi WH, Kim YS (2004) The metabolic syndrome and associated lifestyle factors among South Korean adults. Int J Epidemiol 33: 328–336. - PubMed
    1. Zuo H, Shi Z, Hu X, Wu M, Guo Z, et al. (2009) Prevalence of metabolic syndrome and factors associated with its components in Chinese adults. Metabolism 58: 1102–1108. - PubMed
    1. Gu D, Reynolds K, Wu X, Chen J, Duan X, et al. (2005) Prevalence of the metabolic syndrome and overweight among adults in China. Lancet 365: 1398–1405. - PubMed
    1. Motala AA, Esterhuizen T, Pirie FJ, Omar MA (2011) The prevalence of metabolic syndrome and determination of the optimal waist circumference cutoff points in a rural South african community. Diabetes Care 34: 1032–1037. - PMC - PubMed

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Grant support

The study was supported by the Guangzhou Medical Science Program grant (20121A011120). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.