Prevalence of Metabolic Syndrome in the United States National Health and Nutrition Examination Survey (NHANES) 2011-2018

Importance Metabolic syndrome (MetS) is a cluster of risk factors presaging the development of cardiovascular diseases and diabetes. It is a risk factor for severe coronavirus disease 2019 (COVID-19). Objective To estimate the prevalence of MetS in the US National Health and Nutrition Examination Survey (NHANES) 2011-2018. Design, Setting, and Participants This cohort study included 22370 eligible participants aged ≥20 years from the NHANES 2011-2018. Main Outcome and Measure MetS was defined as the presence of at least three of these components: central obesity, reduced high-density lipoprotein, elevated triglycerides, elevated blood pressure and elevated fasting blood glucose. The prevalence of MetS was estimated taking into account the complex sampling. The time trend was evaluated using logistic regression. Annual percentage changes (APC) were used to measure the trends in MetS prevalence. Results The prevalence of MetS was 36.2% (95% CI, 32.3-40.3), 34.8% (95% CI, 32.3-37.4), 39.9% (95% CI, 36.6-43.2) and 38.3% (95% CI, 35.3-41.3) in 2011-2, 2013-4, 2015-6, 2017-8, respectively ( P for trend =.08). Among the MetS components, the prevalence of elevated glucose increased from 48.7% (95% CI, 45.9-51.5) in 2011-2 to 64.3% (95% CI, 61.0-67.4) in 2017-8 [ P for trend <.001; APC=11.7, (95% CI, 3.5-21.0)]. The prevalence of MetS in non-Hispanic Asian increased from 21.8% (95% CI, 16.7-28.0) in 2011-2 to 31.2% (95% CI, 27.4-35.3) in 2017-8 [ P for trend <.001; APC=14.6, (95% CI, 2.5-34.8)]. Conclusion and Relevance The prevalence of MetS remained stable from 2011 to 2018, but increased among non-Hispanic Asians. Lifestyle modification is needed to prevent metabolic syndrome and the associated risks of diabetes and cardiovascular disease.