Objective: The aim of this study was to investigate causes of the prevalence of the metabolic syndrome in multiparous Omani Arab women using the International Diabetes Federation definition (IDF).

Research Design And Methods: Of 392 married women (mean age 40 years), 354 (90%) were multiparous with an average parity of 8. They were divided into four parity groups: Para 0, Para 1-3, Para 4-6, and Para >6. Body mass index (BMI), waist circumference, fasting, and 2-hour glucose and insulin, plasma lipids, serum leptin, and homeostasis model assessment for insulin resistance (HOMA-IR) and blood pressure (BP) were measured.

Results: In the whole cohort, the IDF definition identified 28% women with the metabolic syndrome, whereas it identified 48% in Para >6. In comparison, the National Cholesterol Education Program (NCEP) definition identified 21% and 39%, respectively (kappa = 0.642). Waist circumference was positively associated with the number of live births (beta = 0.78, p = 0.0001). Compared to other individual IDF criteria, only age-adjusted large waist circumference carried the highest risk for having the metabolic syndrome in all groups (odds ratio [OR], 2.3, 95% confidence interval [CI], 1.0-5.4, 3.2, CI, 1.3-8 and 4.8, CI, 2.1-11.2).

Conclusion: The high prevalence of the metabolic syndrome in multiparous Omani Arab women appeared to be influenced by the parity-related large waist circumference. The high dependency of the IDF criteria on waist circumference for the definition of the metabolic syndrome in this population has led to the misclassification of such women.

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