Journal of Indira Gandhi Institute Of Medical Sciences

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 7  |  Issue : 1  |  Page : 35--38

Prevalence of metabolic syndrome in medical students at tertiary health care center


Sudhir Kumar1, Samir Kumar1, Rekha Kumari2, Ravi Shekhar2,  
1 Department of General Medicine, IGIMS, Patna, Bihar, India
2 Department of Biochemistry, IGIMS, Patna, Bihar, India

Correspondence Address:
Rekha Kumari
Department of Biochemistry, IGIMS, Patna, Bihar
India

Abstract

The most accepted hypothesis to describe the pathophysiology of the metabolic syndrome is insulin resistance, which is caused by a defect in insulin action. It is increasingly recognized worldwide, and estimated that 20%–25% of adult population in south Asia have developed metabolic syndrome. This cross-sectional observational prevalence study of metabolic syndrome was conducted over a period of 1 year (2018–2019) on a sample of 150 randomly selected medical students comprising of different semesters of MBBS course in Indira Gandhi Institute of medical sciences, Patna. The prevalence of metabolic syndrome according to the International Diabetes Federation criteria was 20% comprising 23.3% in males and 17.8% in females. The prevalence of individual parameters for metabolic syndrome was increased waist circumference (42%), low high-density lipoproteins levels (35.3%), increased triglyceride level (32.7%), increased fasting blood sugar (0.02%), and hypertension (0.03%).



How to cite this article:
Kumar S, Kumar S, Kumari R, Shekhar R. Prevalence of metabolic syndrome in medical students at tertiary health care center.J Indira Gandhi Inst Med Sci 2021;7:35-38


How to cite this URL:
Kumar S, Kumar S, Kumari R, Shekhar R. Prevalence of metabolic syndrome in medical students at tertiary health care center. J Indira Gandhi Inst Med Sci [serial online] 2021 [cited 2021 Oct 23 ];7:35-38
Available from: http://www.jigims.co.in/text.asp?2021/7/1/35/318932


Full Text



 Introduction



The term “metabolic syndrome” describes a constellation of cardiovascular risk factors, including hypertension, abdominal obesity, lipid disorder, and insulin resistance. The most accepted hypothesis to describe the pathophysiology of the metabolic syndrome is insulin resistance, which is caused by a defect in insulin action. It is increasingly recognized worldwide and estimated that 20%–25% of adult population in south Asia have developed metabolic syndrome.[1] In India, the incidence of obesity continues to increase and is occurring at a younger age, the prevalence among adolescents varying between 10% and 30%.[2] Obesity is one of the most significant contributors of morbid conditions like metabolic syndrome. The prevalence of metabolic syndrome in obese adolescents has been reported to be between 18% and 42% depending on the country of origin, suggesting an ethnic-based association between obesity and metabolic syndrome.[3] It is estimated that by 2020, cardiovascular disease (CVD) will be the largest cause of disability and death in India, with 2.6 million Indians predicted to die due to CVD.[4] The prevalence of metabolic syndrome in different countries varied from 17% to 37%.[5],[6] Metabolic syndrome is associated with increased risk of morbidity and mortality of various diseases. A meta-analysis including 87 studies and 951,083 subjects demonstrated that metabolic syndrome was associated with a 2-fold increase in the risk for morbidity and mortality of CVD, and a 1.5-fold increase in the risk for all-cause mortality.[7] Excess weight, lack of physical activity, stress, junk food are important causes of the metabolic syndrome.[8],[9] Medical students spend major part of the day at the medical college hospital attending lectures, tutorials, ward, and laboratory. Regular semester examinations and university examination put them under excess stress. They usually avoid sports activity, regular exercise and lead a sedentary lifestyle. This lifestyle is characterized by high levels of sedentariness and stress that may represent an important risk factor for the metabolic syndrome. Irregular food habit along with excess unhealthy food or junk food consumption increases the risk of obesity.[10] The aim of our study was to evaluate the metabolic syndrome parameters (waist circumference, fasting blood sugar [FBS], triglyceride levels [TG], high-density lipoproteins [HDL] level, blood pressure [BP] value), in a population of 150 medical students. In this article, we present baseline findings regarding the prevalence of metabolic syndrome and its main parameters recorded.

 Materials and Methods



This cross-sectional observational study was conducted over a period of 1 year (2018–2019) on a sample of 150 randomly selected medical students comprising of different semesters of MBBS course in Indira Gandhi Institute of Medical Sciences, Patna. This study was conducted in keeping the view of diagnostic criteria for Metabolic Syndrome definition by International Diabetes Federation (IDF).[11] IDF recommends that the metabolic syndrome is said to be present if a person is having waist circumference is higher than the specified cut off value along with any two of the following parameters: TG > or = 150 mg/dl, HDL <40 mg/dl for men, <50 mg/dl for women, BP > or = 130/85 mmHg, FBS > or = 100 mg/dl. The specific cut off value for waist circumference for South Asian male is >90 cm and for South Asian female is >80 cm. Ethical committee approval and informed consent were obtained from the subjects for this study. None of the subjects have been previously diagnosed as a case of diabetes, hypertension, or lipid disorder. All subjects were measured for the following anthropometric parameters: height in meter, weight in kg, and waist circumference in cm. Waist circumference was measured using an inch tape immediately above the iliac crest as defined by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) guidelines.[12] Body mass index (BMI) was calculated as: Weight (kg)/Height2 (meters). BMI between 25 and 29.9 is over weight and 30.0 or higher is obese according to World Health Organization.[13] BP was measured in the right arm supine position and with the following protocol: first measurement was made after at least 5 min of rest and was repeated 3 times. Final data are the average of 3 measurements. Blood samples were collected from the ante-cubital vein, in the early morning, after a minimum of 12 h of fasting period. Biochemical determinations were made in Biochemistry department, IGIMS. Serum TG was estimated by Glycerol 3 phosphate oxidase Trinder method and FBS was estimated by Glucose oxidase and peroxidase method Endpoint colorimetric method. Serum HDL Direct was estimated by the liquid stable reagent. Data were processed using SPSS version. P value was used for statistical analysis. P < 0.05 was considered for statistical significance.

 Results



Out of 150 participants, 60 (40%) were male and 90 (60%) were female [Figure 1]. The mean age was 21.6 years (age range: 18–24 years). The prevalence of metabolic syndrome according to IDF criteria was 20% comprising of 23.3% in males and 17.8% in females. The prevalence of individual parameters for metabolic syndrome was increased waist circumference (42%), low HDL levels (35.3%), increased TG level (32.7%), increased FBS (0.02%), and hypertension (0.03%). In both males and females increased waist circumference was the most common parameter. Increased TG level was the second-most common parameter in males whereas in females the second-most common parameter was low HDL.{Figure 1}

Twenty-three males (38.3%) and 34 females (37.8%) had increased BMI. Nineteen out of the 60 males (31.7%) were overweight and 4 out of the 60 males (6.67%) were obese. Thirty out of the 90 females (33.3%) were overweight and 4 out of the 90 females (5.55%) were obese. Among the diagnosed cases of metabolic syndrome, 22 subjects were overweight and 8 subjects were obese. In our study 93 % students were found to have normal BMI, 49% overweight and 8% were obese [Figure 2]. The prevalence of metabolic syndrome according to BMI and gender is also calculated, in which 23.3% of overweight or obese men and 17.8% of overweight or obese women had metabolic syndrome. No subjects with BMI <25 are found to have metabolic syndrome. While trying to establish a relationship between various lifestyle habits and the presence or absence of metabolic syndrome, we found a significant relationship between metabolic syndrome and lifestyle habits like excess junk food consumption and sedentary life.{Figure 2}

 Discussion



In this present study, the overall prevalence of metabolic syndrome is 20% among medical students (as per IDF criteria). Similar studies conducted among medical students at Bangalore and Sewagram showed the prevalence of metabolic syndrome to be 3.3% (IDF criteria) and 11.2% (NCEP/ATPIII), respectively.[14],[15] In the present study, we found the prevalence of metabolic syndrome to be higher among males compared to females (53% vs. 47 %) [Figure 3]. There are a considerable number of studies showing significant differences in the prevalence of metabolic syndrome among males and females. A higher prevalence in men might be related to higher rates of obesity, high TG, high DBP, and lifestyle habits like smoking and alcohol consumption. As shown in [Table 1], increased TG level was found in 21 male(35%) and 28 female(31%). Decreased level of HDL was found in 18(30%) male and 35(39%) female. Increased fasting plasma glucose level was found in 2(3%) male and 1(1%) female. Hypertension was present in 4(7%) male and 1(1%) female whereas increased waist circumference was found to be 28(47%) in male and 44(49%) in female. Sawant et al. in their study found a higher prevalence of metabolic syndrome in males (2 times) than in females (P < 0.08).[16] In a similar study conducted by Kanitkar et al., the prevalence in males was 24.3% and in females was 20%.[17] In the present study, we found the prevalence of obesity to be 5.3% and overweight 32.7%. In this study, metabolic syndrome is only found to be prevalent in those who are overweight and obese. The prevalence of metabolic syndrome in overweight and obese subjects is 44.8% and 100%, respectively. In a study conducted by Selvaraj and Sivaprakasam among medical students in South India, the prevalence of obesity and overweight were found to be 8.6% and 24.3%, respectively.[18] Sixty-four percent of our subjects consume junk food. Students who are consuming excess junk food, 26% were found to have metabolic syndrome. In our study there is significant association between metabolic syndrome and junk food consumption (P < 0.05) [Table 2]. This is similar to the study done by Jayaraj et al.[19] In another study conducted by Deotale et al. in medical students, there was a significant association between BMI and frequency of junk food consumption.[20] In the present study, there is significant association is found between metabolic syndrome and exercise (P < 0.05) [Table 3]. There are several studies in which sedentary lifestyle/lack of exercise is associated with metabolic syndrome. In a systematic review and meta-analysis study conducted by Yamaoka and Tango, it was concluded that lifestyle modification intervention was effective in resolving metabolic syndrome and reducing the severity of related abnormalities (FBS, WC, BP, and TGs) in subjects with metabolic syndrome.[21] Similar association between exercise and metabolic syndrome was established in other different studies.{Table 1}{Table 2}{Table 3}{Figure 3}

Limitation

A detailed study with large number of subjects is needed. Other factors such as depression, alcohol consumption, and smoking need to evaluated as a possible cause of the metabolic syndrome.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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