Central Adiposity Determines Prevalence Differences of the Metabolic Syndrome

Objective: To compare the expression of the metabolic syndrome in Spain and San Antonio, TX, two populations with major differences regarding their cardiovascular risk profile. Research Methods and Procedures: Cross‐sectional analysis of population‐based, epidemiological surveys using the metabolic syndrome definition of the National Cholesterol Education Program. In San Antonio, we limited our analysis to non‐Hispanic whites because non‐Hispanic whites are largely of European ancestry (n = 1339 in San Antonio and 2947 in Spain) Results: In men, increased central adiposity was more prevalent in San Antonio than in Spain (29.7 vs. 23.0%, p < 0.0001); in women, it was less prevalent in San Antonio than in Spain (40.2 vs. 66.4%, p < 0.0001). The metabolic syndrome followed that same pattern: more prevalent in men (28.9 vs. 20.8%, p = 0.019) and less in women from San Antonio (27.1 vs. 30.9%, p < 0.0001). In subjects with the metabolic syndrome, most women had increased central adiposity (92.6% in San Antonio and 97.5% in Spain), and most men had either increased central adiposity or blood pressure (99.2% in San Antonio and 95.0% in Spain). Discussion: Contrary to men, the metabolic syndrome is more prevalent in Spanish women than in women from San Antonio with differences that mirror differences in central adiposity. Central adiposity and blood pressure may be used to exclude the metabolic syndrome. Considering recent secular trends in obesity, we predict there will be an increase in the prevalence of the metabolic syndrome in both populations in the coming years.