Dr. I.

Selvaraj
Indian Railways Medical Service
B.Sc., M.B.B.S., M.D.,D.P.H., D.I.H., PGCHFW ( NIHFW,New Delhi).,
Life member of Indian Association of Preventive & Social Medicine
Life member of Indian Public Health Association
Life member of Indian Medical Association
 As I am one of the strong supporter of super
course, I am dedicating this presentation to the
public health students (Post graduate Diploma
in Public Health, M.D Community Medicine)
 METABOLIC SYNDROME
• Metabolic syndrome is a cluster of risk factors
which is responsible for excess of
cardiovascular disease morbidity among
overweight and Obese patients and those
persons with type 2 diabetes mellitus.
• The National Cholesterol Education Program-
Adult Treatment Panel (NCEP-ATP III)
identified metabolic syndrome as an
independent risk factor for cardiovascular
disease and considered it an indication for
intensive lifestyle modification.
W.H.O DEFINITION OF MEATBOLIC SYNDROME

INSULIN RESISTANCE+ TWO OF THE FOLLOWING:

1.Abdominal/central obesity:
Waist to hip ratio: > 0.90 (men), > 0.85 (women), or BMI > 30
2. Hypertriglyceridemia: ≥ 150 mg per dL
3. Low HDL cholesterol: < 35 mg perdl for men, < 39 mg per dL for
women
4. High blood pressure: ≥ 140/90 mm Hg or documented use of
antihypertensive therapy
5. High fasting glucose: Impaired glucose tolerance, impaired fasting
glucose, insulin resistance, or diabetes
6. Microalbuminuria Urinary albumin to creatinine ratio: 30 mg per g,
or albumin excretion rate: 20 mcg per minute
Review of literature
A CROSS SECTIONAL STUDY ON
METABOLIC SYNDROME
 JUSTIFICATION OF THE STUDY

•As there is an epidemiological transition from communicable to

non-communicable diseases
•The prevalence of Metabolic syndrome is reported to be very high
in developing countries.
•The components of the metabolic syndrome are important risk
factors for the development of Coronary Heart Diseases and for
Type 2 diabetes.
•Hence this study will be ideal to estimate the prevalence of
Metabolic syndrome in the developing countries
 OBJECTIVE
1. To determine the prevalence of metabolic
syndrome using NCEP adult treatment panel-3
(ATP-3) guidelines
2. To determine the role of lifestyle risk factors
in the development of metabolic syndrome with
particular reference to physical activity,
smoking, diet and alcohol consumption.
CASE DEFINITION:
Metabolic syndrome is defined in accordance with
NCEP - ATP III as the presence of 3 or more of the
following characteristics:
1. Waist circumference > 102 cm in men and > 88 cm in
women
2. Triglyceride levels > or = 150 mg/dl,
3. High density lipoprotein cholesterol < 40 mg/dl in men
and < 50 mg/dl in women
4. Blood pressure > or = 130/85 mm hg
5. and Fasting serum glucose > or = 110 mg/dl.
 METHODS

STUDY DESIGN: Cross sectional study

 SAMPLE SIZE CALCULATION

Sample Size (N) = (Z²×p×q)/L²

Z=1.96 Ordinate value for =5%
p = Prevalence of Metabolic Syndrome
q = 100-p
L = Precision
APPROVAL
1.ETHICS COMMITTEE
2.COMPETENT AUTHORITY
 PILOT STUDY

It will be done to pre- test & pre design the

questionnaire and other procedures
 DATA COLLECTION
• A structured questionnaire comprising
information on social demographic, behavioral
and clinical characteristics.
• Anthropometrics measurement
• Blood pressure( JNC VII)
• Fasting blood sample of glucose and Lipid
Profile
 ANALYSIS
• Data analysis by using appropriate
available software package
• Prevalence of Metabolic syndrome as
point estimate and 95% C.I for precision
• Odds Ratio for the risk factors of
Metabolic syndrome
• Logistic regression to find out the
adjusted Odds Ratio & 95% C.I