Metabolic syndrome in rural Kerala: a hospital based study


  • Shuba Srinivasan Associate Professor, Department of Medicine, DM Wayanad Institute of Medical Sciences, Wayanad, Kerala, India
  • Jyothi B. Lingegowda Associate Professor, Department of Pathology, Department of Immunohematology and Transfusion Medicine, Vinayaka Missions Kirupananda Variyar Medical College, Salem, Tamil Nadu, India
  • Chinnappa Rajan Professor and HOD, Department of Medicine, DM Wayanad Institute of Medical Sciences, Wayanad, Kerala, India
  • Prakash H. Muddegowda Associate Professor, Department of Immunohematology and Transfusion Medicine, Vinayaka Missions Kirupananda Variyar Medical College, Salem, Tamil Nadu, India
  • Ramkumar Kurpad R. Consultant and Head of laboratory services, Department of Pathology, Mediheal Hospital, Kenya



Central obesity, Hospital, Metabolic syndrome, NCEP ATPIII, Rural


Background: Metabolic syndrome refers to a cluster of various interrelated cardio-metabolic risk factors that promote the development of atherosclerotic cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Identifying at risk individuals is necessary for early medical management, thereby reducing the economic burden on the patient and the society. The objective of this study was to assess the prevalence of metabolic syndrome in patients presenting to medicine clinics of our institute.

Methods: This cross-sectional hospital based study was carried out at department of medicine, DM Wayanad institute of medical sciences, Wayanad, Kerala and included 432 patients attending the general medicine outpatient department. Patients’ demographic details and anthropometric measurements including height, weight, waist and hip measurements were taken. Clinical data including blood pressure, blood sugars and fasting lipid profile was also collected. The NCEP ATP III (National cholesterol education program - adult treatment panel III) criteria for diagnosis of metabolic syndrome were used to make a diagnosis of metabolic syndrome.

Results: On applying the modified NCEP ATP III guidelines with the waist circumference specific to Asian population, we found that the prevalence of metabolic syndrome in our study population was 60.9%. The prevalence was more in females than in males and the difference was statistically significant (p = 0.049). Abdominal obesity and decreased HDL was more in females as compared to males and the difference was also found to be statistically significant. 27% of the study population with metabolic syndrome was normal or underweight.

Conclusions: The prevalence of metabolic syndrome in the present studied population was high as they represent patients presenting to hospital. This data is more like the tip of an iceberg. Larger population based studies and intervention in the form of aggressive lifestyle modification is the need of the hour to prevent the cardio-metabolic complications of metabolic syndrome.


Sivasankaran S, Thankappan KR. Prevention of non-communicable diseases requires a life course approach: A case study from Kerala. Indian J Med Res. 2013;137:874-7.

Pathania D, Bunger R, Mishra P, Pathak R, Arora A. A study to assess prevalence of metabolic syndrome and its socio demographic risk factors in rural area of district Ambala, Haryana. J Community Med Health Educ. 2013;3(5):226.

Prasad DS, Kabir Z, Dash AK, Das BC. Prevalence and risk factors for metabolic syndrome in asian Indians: a community study from urban eastern India. J Cardio Dis Res. 2012;3(3):204-11.

Surana SP, Shah DB, Gala K, Susheja S, Hoskote SS, Gill N, et al. Prevalence of metabolic syndrome in an Urban Indian Diabetic population using the NCEP ATP III guidelines. J Assoc Physic India. 2008;56:865-8.

Misra A, Misra R, Wijesuriya M, Banerjee D. The metabolic syndrome in South Asians: continuing escalation and possible solutions. Indian J Med Res. 2007;125(3):345-54.

Kaur J. A comprehensive review on Metabolic syndrome. Cardiology research and practice. Cardiol Res Pract. 2014;2014:943162.

Cameron AJ, Shaw JE, Zimmet PZ. The metabolic syndrome: prevalence in worldwide populations. Endocrinol Metab Clin North Am. 2004;33(2):351-75.

Anjana M, Sandeep S, Deepa R, Vimaleswaran KS, Farooq S, Mohan V. Visceral and central abdominal fat and anthropometry in relation to diabetes in Asian Indians. Diabetes Care. 2004;27(12):2948-53.

Maumus S, Marie B, Siest G, Visvikis-Siest S. A prospective study on the prevalence of metabolic syndrome among healthy French families: two cardiovascular risk factors (HDL cholesterol and tumor necrosis factor- alpha) are revealed in the offspring of parents with metabolic syndrome. Diabetes care. 2005;28(3):675-82.

Selvaraj I, Gopalakrishnan S, Lograj M. Prevalence of metabolic syndrome among rural women in a primary health centre area in Tamil Nadu. Indian J Public Health. 2012;56(4):314-7.

Bentley-Lewis R, Koruda K, Seely EW. The metabolic syndrome in women. Nat Clin Pract Endocrinol Metab. 2007;3(10):696-704.

Enas EA, Mohan V, Deepa M, Farooq S, Pazhoor S, Chennikara H. The metabolic syndrome and dyslipidemia among Asian Indians: a population with high rates of diabetes and premature coronary artery disease. J Cardiometab Syndr. 2007;2(4):267-75.

Jacob B, George AT, Antony TP, Jose R, Sebastian SR. Prevalence of metabolic syndrome in newly detected type 2 diabetes mellitus. Academia Medical Journal of India 2015;3(1). Available at

Accessed on 24 September 2016.

Ramachandran A, Snehalatha C, Satyavani K, Sivasankari S, Vijay V. Metabolic syndrome in urban Asian adults a population study using modified ATP III criteria. Diabetes Res Clin Pract. 2003;60(3):199-204.

Thappa DM, Gupta D. Prevalence of metabolic syndrome in South Indian patients with psoriasis vulgaris and the relation between disease severity and metabolic syndrome: a hospital-based case-control study or cross-sectional study? Indian J Dermatol. 2013;58(4):315.

Moini A, Javanmard F, Eslami B, Aletaha N. Prevalence of metabolic syndrome in polycystic ovarian syndrome women in a hospital of Tehran. Iran J Reprod Med. 2012;10(2):127-30.

Oliveira BM, Medeiros MM, de Cerqueira JV, de Souza Quixada RT, Oliveira IM. Metabolic syndrome in patients with rheumatoid arthritis followed at a university hospital in North eastern Brazil. Rev Bras Reumatol Engl Ed. 2016;56(2):117-25.

Lin CH, Lai SW, Liu CS. Prevalence of metabolic syndrome in Taiwanese adults: a hospital - based study. Ann Saudi Med. 2006;26(1):46-8.

Zeller M, Steg PG, Ravisy J, Laurent Y, Janin-Manificat L, L’Huillier I, et al. Prevalence and impact of metabolic syndrome on hospital outcomes in acute myocardial infarction. Arch Intern Med. 2005;165(10):1192-8.

Gisondi P, Tessari G, Conti A, Piaserico S, Schianchi S, Peserico A, et al. Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based case-control study. Br J Dermatol. 2007;157(1):68-73.

Salvi V, D’Ambrosio V, Rosso G, Bogetto F, Maina G. Age-specific prevalence of metabolic syndrome in Italian patients with bipolar disorder. Psych Clin Neuro Sci. 2011;65:47-54.

Enas EA, Yusuf S, Mehta JL. Prevalence of coronary artery disease in Asian Indians. Am J Cardiol. 1992;70(9):945-9.

Pradeepa S, Surendar J, Indulekha K, Chella S, Anjana RM, Mohan V. Prevalence of metabolic syndrome and its association with coronary artery disease among an urban elderly south Indian population (CURES 145). J Assoc Physicians India. 2016;64:20-5.

Ismail IM, Azeez K, Antomy A, Kunnummal SV. Metabolic syndrome and its associated factors among the adult population residing in Kannavam tribal area of Kannur District, Kerala. Trop J Med Res. 2016;19:36-41.






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