Objective: The aim of this study was to assess the prevalence of metabolic syndrome (MS) and its association with coronary artery disease (CAD) among an elderly urban population in south India.

Methods: Individuals aged ≥60 years (n=222) were recruited from Phase 3 of the Chennai Urban Rural Epidemiology Study. Anthropometric and blood pressure measurements, oral glucose tolerance test, lipids and fasting insulin were carried out. Prevalence of MS was estimated using the World Health Organization (WHO), Modified National Cholesterol Education Program's Adult Treatment Panel III (ATP-III) and International Diabetes Federation (IDF) criteria. Diagnosis of CAD was made by resting 12 lead ECG and/or past history of documented myocardial infarction.

Results: MS was identified in 45.9% (n=102) by modified ATP-III, 37.4% (n=83) by IDF and 45.5% (n=101) by WHO criteria respectively. Only 61 subjects (27.5%) were identified by all the three criteria. Female subjects had a significantly higher prevalence of MS compared to their male counterparts (45.8 vs, 31.0%, p=0.023 respectively) according to IDF criteria. It was observed that 59.8%, 53% and 45.6% of the subjects had all five abnormalities according to modified ATP-III, IDF and WHO, respectively. Subjects with MS had significantly higher prevalence of CAD compared to those without MS using all the 3 criteria (modified ATP-III -20.6 vs.8.5%; IDF-20.5 vs.10.1%; WHO-19.8 vs.9.1% respectively). The odds ratio of developing CAD among MS subjects was 2.93, 2.39 and 2.48 compared to those without MS after adjusting for age, gender and family history of diabetes according to modified ATP-III, IDF and WHO, respectively.

Conclusions: Nearly 40% of the elderly urban south Indians have MS and it is strongly associated with CAD.

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