Prevalence of metabolic syndrome in Pakistan.

Over the past two decades, there has been a striking increase in the number of people with metabolic syndrome. The prevalence of metabolic syndrome varies due to lack of an internationally agreed upon definition. Considering the increased cardiovascular risk among Asian people, a lower cutoff for waist circumference is defined. Obesity in terms of waist circumference is found to be 46-68% of the Pakistani population, with a strong association found between arm fat and insulin insensitivity. In studying dyslipidemia, hypertriglyceridemia is found in 27-54% of the population, whereas 68-81% have low levels of high-density lipoprotein (HDL). Fifty percent were found to be at high risk of metabolic syndrome and as being hypertensive. With the high prevalence of all of these metabolic risk factors, the prevalence of metabolic syndrome in Pakistan according to different definitions is reported to be from 18% to 46%, comparable to the data from other South Asian countries. Thus, metabolic syndrome should be considered as a prime target for preventive medicine. The primary management goals for metabolic syndrome are to reduce the risks of cardiovascular disease and diabetes. Lifestyle-related risk factors are associated with the metabolic syndrome and diabetes. Unless preventive programs are properly designed and implemented, we will continue to treat the majority of the cases after they have already developed the complications. A prospective primary prevention study is underway in Pakistan that will help to create a base for public awareness strategies and nationwide surveillance and prevention programs against noncommunicable diseases.