Home | About us | Editorial board | Search | Ahead of print | Current issue | Archives | Submit article | Instructions | Subscribe | Contacts | Advertise | Login 
Search Article 
Advanced search 
  Users Online: 1364 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  

Table of Contents
Year : 2012  |  Volume : 16  |  Issue : 1  |  Page : 67-71

Metabolic syndrome in the Middle East

1 Department of Internal Medicine, Suez Canal University, Egypt
2 Department of Endemic and Infectious Disease, Suez Canal University, Egypt

Date of Web Publication26-Dec-2011

Correspondence Address:
Hamdy Ahmed Sliem
Ismailia, Post code 41522
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2230-8210.91193

Rights and Permissions

Metabolic syndrome (MS) is a combination of medical disorders that, in concert, increase the risk of developing cardiovascular disease and diabetes. It affects about one in four people in the Middle East, and prevalence increases with age. The aim of current review is to discuss the prevalence of MS and its component in different regions in the Middle East. The recorded high prevalence of the MS and its key cardiovascular risk factors (15-60%) among Middle East population mandates the need for a national and international prevention programs to combat obesity, diabetes, hypertension, dyslipidemia, smoking and related comorbidities. Consideration of early prevention and control is of utmost importance.

Keywords: Metabolic syndrome, Middle East, obesity

How to cite this article:
Sliem HA, Ahmed S, Nemr N, El-Sherif I. Metabolic syndrome in the Middle East. Indian J Endocr Metab 2012;16:67-71

How to cite this URL:
Sliem HA, Ahmed S, Nemr N, El-Sherif I. Metabolic syndrome in the Middle East. Indian J Endocr Metab [serial online] 2012 [cited 2021 Jul 24];16:67-71. Available from: https://www.ijem.in/text.asp?2012/16/1/67/91193

   Introduction Top

Almost three decades ago, Dr Gerald Reaven identified a cluster of physiologic and metabolic characteristics that seek the company of one another. Originally known as "syndrome X", the cluster has also been termed pluri-metabolic syndrome (MS), or Reaven's syndrome. These characteristics, when found in the same person, are so ominous that they have also been called "the deadly quartet" or "the awesome foursome". [1] Reaven and subsequently others postulated that insulin resistance underlies Syndrome X (hence the commonly used term insulin resistance syndrome). [2],[3] Other researchers use the term MS for this clustering of metabolic risk factors. The National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III) used this alternative. It consists of multiple, interrelated risk factors of metabolic origin that appear to directly promote the development of atherosclerotic cardiovascular disease. Five factors, identified NCEP-ATP III, are thought to comprise this syndrome-large waist circumference (WC; as indicator of central obesity), elevated triglycerides (TG), low high-density lipoprotein cholesterol (HDL-C) concentration, high blood pressure and elevated fasting plasma glucose. The concomitant presence of 3 or more of these confers an approximate 2-fold increased risk of atherosclerotic cardiovascular disease (CVD) and an approximate 5-fold increased risk of diabetes mellitus. [4] Other associated changes have also been described, including microalbuminuria, a prothrombotic and proinflammatory state.

   Definition Top

Although the risk associated with the MS is well-documented, the definition of the syndrome is still in flux. To define any diagnostic criteria is not easy. It is even more complicated - what parameters, what thresholds, and what combinations should be used to define it?. In the absence of a diagnostic test, a number of definitions of the syndrome have been proposed. [5] They come from the World Health Organization (WHO), the European Group for the study of Insulin Resistance (EGIR), J-P Després' group and NCEP-ATP III. [4],[6],[7] These various definitions include different factors and different thresholds for them. [5] For example the first definition, from the WHO, included microalbuminuria, which does not appear in the later definitions. [8] The EGIR definition did not include diabetic patients. [6] The most recent definitions are from the International Diabetes Federation (IDF) and from the American Heart Association/National Heart, Lung and Blood Institute AHA/NHLBI. [9],[10],[11] The differences between these definitions are essentially the thresholds for the parameters to define a syndrome abnormality, the number of abnormalities before the syndrome is deemed to be present, and whether there is a compulsory abnormality which is required to be present. The IDF definition, with its differing thresholds for WC according to ethnic group, is likely to become the international norm, as it is supported by several international bodies. [5]

   Prevalence of Metabolic Syndrome in the Middle East Top

Many reports have been published on the prevalence of the MS in the Middle East. A survey in Turkey reported a prevalence of 33.9% for MS, with a higher prevalence in women (39.6%) than in men (28%). The survey included random samples from both urban and rural populations in seven geographical regions of Turkey using ATP III guideline. The population for this analysis were 2108 men (1372 in urban and 736 in rural areas) and 2151 women (1423 in urban and 728 in rural areas) with a mean age of 40.9+/-14.9 years (range 20-90). [12] Another study was executed under the population study "The Healthy Nutrition for Healthy Heart Study" conducted between December 2000 and December 2002 by the Health Ministry of Turkey. Overall, 15,468 Caucasian inhabitants aged over 30 were recruited in 14 centers in different regions of Turkey. Overall, more than one-third (35.08%) of the participants were obese. The hypertensive people ratio in the population was 13.66%, while these ratios for diabetes mellitus and MS were 4.16% and 17.91%, respectively. The prevalence of hypertension, MS and obesity were higher in females than males, whereas diabetes mellitus was higher in males than females. [13]

In a study in Tunisia, MS prevalence was 45.5% based on the IDF criteria and 24.3% according to the ATP III definition, with significantly higher prevalence in women than in men. The two most common components were increased WC and low HDL-C. The study was a cross-sectional population-based survey, conducted in 1996 on a large nationally representative sample, which included 3435 adults (1244 men and 2191 women) of 20 years or older. Based on the ROC analysis, WC of 85 cm for both men and women was suggested as appropriate cut-off points to identify central obesity for the purposes of CVD and diabetes-risk detection among Tunisians. [14]

A study of adult female Saudi subjects found the prevalence of MS to be 16.1% and 13.6% according to IDF and ATP III definitions, respectively. Prevalence of the MS was reported at 21.0% in one city in Oman, with low HDL (75.4%) and increased WC as the two most common components.

In a population in Northern Jordan, according to the ATP III definition, the prevalence of the MS was 36.3%, with a significantly higher prevalence in women than in men. The most common abnormality was low HDL-C in men (62.7%) and increased WC in women (69.1%). A cross-sectional survey conducted in 2005 to determine the prevalence of MS and other atherosclerotic cardiovascular disease risk factors among a sample of 342 Palestinians > or = 20 years in East Jerusalem. MS was found in 115 (33.6%) participants, with no significant difference between the sexes. The prevalence of obesity, diabetes and other cardiovascular risk factors was also high, with central obesity and obesity (BMI > or = 30 kg/m 2 ) being significantly higher in women.

In a community-based, cross-sectional survey for establishing the normal value for WC among a rural district population in Basrah (Iraq), the optimal cutoff point for WC for the diagnosis of MS in the Iraqi adult rural population as 99 cm in women and 97 cm in men was proposed. [15],[16],[17]

Larger studies on the prevalence of MS in the Middle East have also been published. Nation-wide survey was conducted in 2007 on 3024 Iranians aged 25-64 years living in urban and rural areas of all 30 provinces in Iran. The age-standardized prevalence of the MS was about 34.7% based on the ATP III criteria, 37.4% based on the IDF definition, and 41.6% based on the ATPIII//AHA/NHLBI criteria. By all definitions, the prevalence of the MS was higher in women, in urban areas, and in the 55-64-year age group compared to men, rural areas and other age groups, respectively. The burden of the MS was estimated to affect more than 11 million Iranians. [18]

A multinational study evaluated the prevalence and effect of MS on patients with acute coronary syndrome (ACS). The Gulf Registry of Acute Coronary Events prospectively enrolled 8716 patients with ACS from 65 centers in six Middle Eastern countries (Bahrain, Kuwait, Qatar, Oman, United Arab Emirates, and Yemen). Patients were evaluated for the presence of MS based on IDF diagnostic criteria. MS was highly prevalent among Middle Eastern patients presenting with ACS. MS was associated with higher risk profile characteristics and increased risk for development of heart failure and recurrent myocardial ischemia without an increase in hospital mortality. [19]

In a nationwide exercise, six thousand seven hundred and seventy three adult individuals (mean age 48 years ± 4, 42% were males and 58% were females) were screened for the key cardiovascular risk factors in Egypt. [20] Central obesity diagnosed by increased WC, > 102/88 cm (men/women), was markedly high in both men and women participating in the study. In addition, body mass index (BMI) which reflects total body obesity (> 30 kg/m 2 ) was also high. Central obesity was estimated in the study to be 29% with a more prevalence in women. This is comparable to what was reported from several western countries, such as the United States (28.0% of men and 34.0% of women in a Survey of 4115 adult men and women conducted in 1999 and 2000 as part of the National Health and Nutrition Examination Survey , a nationally representative sample of the US population) [21] and the United Kingdom (23.0% in men and 25.0% in women). [22] This similarity could be due to common exogenous factors existing in the developing countries leading to the development of the MS such as sedentary life, psychosocial stressors and obesity.

   Prevalence of Obesity in the Middle East Top

Obesity is a corner stone of the MS as an etiology or a sequel. It constitutes one of the elements of MS diagnosis. [23] Among different countries in the Middle East region there is significant heterogeneity in obesity (BMI>30 kg/m 2 ) prevalence.

Arab countries including Oman show prevalence of 30.8%, Qatar (40.8%), and Gaza and West Bank (41.5%) which is an extremely high prevalence of obesity. A community based cross-sectional survey representing all parts of Oman was designed in the year 2000. The crude prevalence of overweight and obesity (body mass index >25 kg/m 2 ) was 47.9% for the whole sample, and 46.2% for males, 49.5% for females. The crude prevalence of central obesity (abnormal weight hips ratio) was 49.3% for the whole sample, 31.5% for males, and 64.6% for females. [15],[24] Overall, obesity was also found in several studies to be more prevalent in urban areas compared with rural regions. This is most likely because of rapid economic and nutritional transitions in this region as well as definite lifestyle changes. People became less sedentary and consuming more calories through non-healthy fast foods. Also, the overall prevalence of obesity in the Middle East region was considerably higher among women compared with men.

Although the exact explanation of such gender variations is not entirely clear, it has been reported that women are less active compared with men in certain areas. Physical and cultural barriers to physical activity have been reported among women in Egypt and Saudi Arabia. [25],[26] These include climatic conditions of extreme heat in the summer, limited exercise facilities devoted solely for women, lack of physical education or an emphasis on its importance in schools, and absence of women's participation in organized sports. Physical inactivity and sedentary lifestyle are major risk factors for the development of obesity and CVD.

New Egyptian WC cutoff points for abdominal obesity were developed based upon data from the Egyptian National Hypertension Project (ENHP). [27] These are 97.5 cm for men and 92.3 cm for women. Cutoff points recommended by IDF were 94 cm for men and 80 cm for women derived from the European cutoff points. [28] The prevalence of abdominal obesity in Egyptians based upon these European cutoff points was 30.2% for men and 70.9% for women while based on new Egyptian criteria, the prevalence of abdominal obesity in men was 37.1% and in women 50.8%. [20]

   Metabolic Syndrome in Children and Adolescents Top

Among Egyptian healthy adolescents 10 to 18 years of age, the overall prevalence of the MS was 7.4% with no sex or area of residence predilection. Results showed that adolescents with the full criteria of MS constituted nearly one-fourth of those exhibiting high values of different components, except for systolic blood pressure, where they were 42%, and TG, where they were 31%. Family history of obesity and diabetes mellitus increased the odds for MS significantly as well as inactivity. A high level of C-reactive protein was reported among affected adolescents. Homocysteine level did not have an influence on the prevalence of MS. [29]

In Lebanon, according to ATP III definition, the MS was identified in 26.4 and 4% of obese and overweight children, respectively, with a higher prevalence among girls than boys. The most common abnormalities among subjects with MS were elevated WC (100.0%), high triglyceride (91.7%) and low high-density lipoprotein cholesterol (66.7%) levels. Insulin resistance was identified in 70% of obese children and 75% of those having the MS. [30]

   International Comparisions Top

In other areas in the world, different studies report quite varied effects of gender on the MS in different populations using ATP III definition. In USA, MS is more prevalent in white males than in females. [31] In American blacks, Mexican Americans, Korea, Iran, India and Oman, women had higher prevalence of the MS than men. [32],[33],[34],[35] The combination of abdominal obesity and dyslipidemia was also reported as the most common combination among Chinese type-2 diabetics with MS. [36] Abdominal obesity is reported as one of the most prevalent risk factor among patients with MS in Greece. A cross-sectional analysis of a representative sample of Greek adults (4753 participants older than 18 years) were included in the final analysis. The age-standardized prevalence of the MS was 23.6%. The prevalence increased with age in both sexes. Depending on ATP III criteria, most of those with MS had three components of the syndrome (61%), 29% had four and 10% had all five components. Abdominal obesity (82%) and arterial hypertension (78%) were the most common abnormalities. [37]

It is well-documented that Asians have ethnic predisposition to adverse body fat distribution and MS, hence optimal cutoff points for WC have been established for South Asians. By using this cutoff, the prevalence of the MS in this populations is estimated to be10-30%. [38] In India, a target sample of 1,800 adults (men 960, women 840) were randomly selected for epidemiological study among urban subjects in western India to determine prevalence of diabetes, MS and their risk factors. MS (using ATP III definitions) was present in 52 men (9.8%) and 114 women (20.4%) with age-adjusted prevalence of 7.9% in men and 17.5% in women with an overall prevalence of 12.8%. Other metabolic abnormalities of MS in men and women were high triglycerides in 32.1 and 28.6%, low HDL cholesterol in 54.9 and 90.2%; central obesity in 21.8 and 44.0%, and high normal blood pressure or hypertension in 35.5 and 32.4%. [34] In Pakistan, one study in Pakistan Institute of Medical Sciences showed a very high prevalence of the MS in type 2 diabetic population. Out of 106 patients, 91 (85.8%) had MS of whom 95% were females. Abdominal obesity was present in 91% females and 86% males. Low HDL levels were present in all females and 83% males. 78% females and 63% males had elevated levels of triglycerides. Hypertension was present in 68% and 73% females and males, respectively. Females were more affected than males in all respects. Thus, it appears that low HDL cholesterol and large WC are responsible for the high prevalence of MS in women in many populations. [39]

   Conclusions Top

As the syndrome does not have a known single cause,no single modality of treatment is able to manage MS. To delay the appearance of the syndrome or its manifestations, insulin sensitivity could be targeted, by lifestyle modification - loss of weight, increase in physical activity, a healthy diet or by pharmacological intervention. To treat the abnormalities of the MS, the first step is lifestyle modification, and even modest weight loss may be effective. [40] Drug treatment should be used for the specific abnormalities according to current guidelines, and a more aggressive approach may be appropriate when more than one abnormality is present. [5]

The present review has highlighted the high prevalence of MS in adults and children across th Middle East. This epidemic has great negative public health potential, which is not limited to any single country, age group or gender. National health authorities in the Middle East, as well as across the globe, need to take immediate and urgent action to arrest the MS epidemic. Raising awareness about this lurking disease is but the first step in ensuring affirmative and aggressive action in tackling MS in the Middle East.

   References Top

1.Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988;37:1595-607.  Back to cited text no. 1
2.Haffner SM, Valdez RA, Hazuda HP, Mitchell BD, Morales PA, Stern MP. Prospective analysis of the insulin-resistance syndrome (syndrome X). Diabetes 1992;41:715-22.  Back to cited text no. 2
3.Han TS, Sattar N, Williams K, Gonzalez-Villalpando C, Lean ME, Haffner SM. Prospective Study of C-Reactive Protein in relation to the development of diabetes and metabolic syndrome in the Mexico City Diabetes Study. Diabetes care 2002;25:2016-21.  Back to cited text no. 3
4.Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): JAMA 2001;285:2486-97.  Back to cited text no. 4
5.Balkaua B, Valensic P, Eschwègea E, Slam G. A review of the metabolic syndrome. Diabetes Metab 2007;(33):405-13.  Back to cited text no. 5
6.Balkau B, Charles MA. Comment on the provisional report from the WHO consultation. European Group for the Study of Insulin Resistance (EGIR). Diabet Med 1999;16:442-3.  Back to cited text no. 6
7.Lemieux I, Pascot A, Couillard C, Lamarche B, Tchernof A, Almeras N, et al. Hypertriglyceridemic waist: A marker of the atherogenic metabolic triad (hyperinsulinemia; hyperapolipoprotein B; small, dense LDL) in men? Circulation 2000;102:179-84.  Back to cited text no. 7
8.World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications. Report of a WHO consultation. 1999. Available from: http://www.whqlibdoc.who.int/hq/1999/WHO_NCD_NCS_99.2.pdf. [Last accessed on 2011 June 16].  Back to cited text no. 8
9.Einhorn D, Reaven GM, Cobin RH, Ford E, Ganda OP, Handelsman Y, et al. American College of Endocrinology position statement on the insulin resistance syndrome. Endocr Pract 2003;9:237-52.  Back to cited text no. 9
10.Alberti KG, Zimmet P, Shaw J. IDF Epidemiology Task Force Consensus Group. The metabolic syndrome-a new worldwide definition. Lancet 2005;366:1059-62.  Back to cited text no. 10
11.Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and Management of the Metabolic Syndrome. An American Heart. Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-52.  Back to cited text no. 11
12.Kozan O, Oguz A, Abaci A, Erol C, Ongen Z, Temizhan A, et al. Prevalence of the metabolic syndrome among Turkish adults. Eur J Clin Nutr 2007;61:548-53.  Back to cited text no. 12
13.Sanisoglu SY, Oktenli C, Hasimi A, Yokusoglu M, Ugurlu M. Prevalence of metabolic syndrome-related disorders in a large adult population in Turkey. BMC Public Health 2006;6:92.  Back to cited text no. 13
14.Bouguerra R, Alberti H, Smida H, Salem LB, Rayana CB, El Atti J, et al. Waist circumference cut-off points for identification of abdominal obesity among the Tunisian adult population. Diabetes Obes Meta 2007;9:859-68.  Back to cited text no. 14
15.Motlagh B, O′Donnell M, Yusuf S. Prevalence of cardiovascular risk factors in the Middle East: A systematic review. Eur J Cardiovasc Prev Rehabil 2009;16:268-80.  Back to cited text no. 15
16.Mansour AA, Al-Hassan AA, Al-Jazairi MI. Cut-off values for waist circumference in rural Iraqi adults for the diagnosis of metabolic syndrome. Rural Remote Health 2007;7:765.  Back to cited text no. 16
17.Abu Sham′a RA, Darwazah AK, Kufri FH, Yassin IH, Torok NI. MetS and cardiovascular risk factors among Palestinians of East Jerusalem. East Mediterr Health J 2009;15:1464-73.  Back to cited text no. 17
18.Delavari A, Hossein M, Alikhani S, Sharifian A. The First Nationwide study of the prevalence of the metabolic syndrome and optimal cut-off points of waist circumference in the Middle East: The national survey of risk factors for non-communicable diseases of Iran. Diabetes Care 2009;32:1092-7.   Back to cited text no. 18
19.Al Suwaidi J, Zubaid M, El-Menyar AA, Singh R, Rashed W, Ridha M, et al. Prevalence of the metabolic syndrome in patients with acute coronary syndrome in six middle eastern countries. J Clin Hypertens (Greenwich) 2010;12:890-9.  Back to cited text no. 19
20.Nasr GM, Sliem H, Gamal A, Refaat Hyam, Mahmoud I. Screening for Diabetes and Cardiovascular Risk Factors among Egyptian population. Clinical Diabetes (middle east edition) 2010;9:127-35.  Back to cited text no. 20
21.Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999-2000. JAMA 2002;288:1723-7.  Back to cited text no. 21
22.Rennie KL, Jebb SA. Prevalence of obesity in Great Britain. Obes Rev 2005;6:11-2.  Back to cited text no. 22
23.Lean ME. Pathophysiology of obesity. Proc Nutr Soc 2000;59:331-6.  Back to cited text no. 23
24.Al-Riyami AA, Afifi MM. Prevalence and correlates of obesity and central obesity among Omani adults. Saudi Med J 2003;24:641-6.  Back to cited text no. 24
25.Khalid ME. The association between strenuous physical activity and obesity in high and low altitude populations in southern Saudi Arabia. Int J Obes Relat Metab Disord 1995;19:776-80.  Back to cited text no. 25
26.Taha AZ, Bella H. Heart disease risk factors: Prevalence and knowledge in primary care settings, Saudi Arabia. East Mediterr Health J 1998;4:293-300.  Back to cited text no. 26
27.Ibrahim MM. Hypertension surveys in the developing world. Lessons from the Egyptian National Hypertension Project (NHP). J Human Hypertens 1997;11:709-26.  Back to cited text no. 27
28.Tan CE, Ma S, Wai D, Chew SK, Tai ES. Can we apply the National Cholesterol Education Program Adult Treatment Panel definition of the metabolic syndrome to Asians? Diabetes Care 2004;27:1182-6.   Back to cited text no. 28
29.Aboul Ella NA, Shehab DI, Ismail MA, Maksoud AA. Prevalence of metabolic syndrome and insulin resistance among Egyptian adolescents 10 to 18 years of age. J Clin Lipidol 2010;4:185-95.   Back to cited text no. 29
30.Nasreddine L, Ouaijan K, Mansour M, Adra N, Sinno D, Hwalla N. Metabolic syndrome and insulin resistance in obese prepubertal children in Lebanon: A primary health concern. Ann Nutr Metab 2010;57:135-42.  Back to cited text no. 30
31.Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB. The metabolic syndrome: Prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med 2003;163:427-36.  Back to cited text no. 31
32.Chuang SY, Chen CH, Tsai ST, Chou P. Clinical identification of the metabolic syndrome in Kinmen. Acta Cardiologica Sinica 2002;18:16-23.  Back to cited text no. 32
33.Azizi F, Salehi P, Etemadi A, Zahedi-Asl S. Prevalence of metabolic syndrome in an urban population: Tehran Lipid and Glucose Study. Diabetes Res Clin Pract 2003;61:29-37.  Back to cited text no. 33
34.Gupta A, Gupta R, Sarna M, Rastogi S, Gupta VP, Kothari K. Prevalence of diabetes, impaired fasting glucose and insulin resistance syndrome in an urban Indian population. Diabetes Res Clin Pract 2003;61:69-76.  Back to cited text no. 34
35.Park JS, Park HD, Yun JW, Jung CH, Lee WY, Kim SW. Prevalence of the metabolic syndrome as defined by NCEP-ATP III among the urban Korean population. Korean J Med 2002;63:290-8.  Back to cited text no. 35
36.Lee YJ, Tsai JC. ACE gene insertion/deletion polymorphism associated with 1998 World Health Organization definition of metabolic syndrome in Chinese type 2 diabetic patients. Diabetes Care 2002;25:1002-8.  Back to cited text no. 36
37.Athyros VG, Bouloukos VI, Pehlivanidis AN, Papageorgiou AA, Dionysopoulou SG, Symeonidis AN, et al. The prevalence of the metabolic syndrome in Greece: the MetS-Greece Multicentre Study. Diabetes Obes Metab 2005;7:397-405.  Back to cited text no. 37
38.Nestel P, Lyu R, Low LP, Sheu WH, Nitiyanant W, Saito I, et al. Metabolic syndrome: Recent prevalence in East and Southeast Asian populations. Asia Pac J Clin Nutr 2007;16:362-7.  Back to cited text no. 38
39.Mohsin A, Zafar J, Nisar YB, Imran SM, Zaheer K, Khizar B, et al. Frequency of the metabolic syndrome in adult type2 diabetics presenting to Pakistan Institute of Medical Sciences. J Pak Med Assoc 2007;57:235-9.   Back to cited text no. 39
40.Hillier TA, Fagot-Campagna A, Eschwège E, Vol S, Cailleau M, Balkau B, et al. Weight change and changes in the metabolic syndrome as the French population moves towards overweight: The D.E.S.I.R. Cohort. Int J Epidemiol 2006;35:190-6.  Back to cited text no. 40

This article has been cited by
1 A nationwide study of metabolic syndrome prevalence in Iran; a comparative analysis of six definitions
Ozra Tabatabaei-Malazy,Sahar Saeedi Moghaddam,Nazila Rezaei,Ali Sheidaei,Mohammad Javad Hajipour,Negar Mahmoudi,Zohreh Mahmoudi,Arezou Dilmaghani-Marand,Kamyar Rezaee,Mahdi Sabooni,Farideh Razi,Farzad Kompani,Alireza Delavari,Bagher Larijani,Farshad Farzadfar,Ming Liu
PLOS ONE. 2021; 16(3): e0241926
[Pubmed] | [DOI]
2 Hesperidin-An Emerging Bioactive Compound against Metabolic Diseases and Its Potential Biosynthesis Pathway in Microorganism.
Naymul Karim,Mohammad Rezaul Islam Shishir,Vemana Gowd,Wei Chen
Food Reviews International. 2021; : 1
[Pubmed] | [DOI]
3 Hypolipidemic activity of an ethanolic extract of quinoa seeds in Triton X-100-induced hyperlipidemic rats
Mohamed A. Hashem,Essam A. Mahmoud,Noura A. Abd-Allah
Comparative Clinical Pathology. 2021;
[Pubmed] | [DOI]
4 The Prevalence of Metabolic Syndrome in Ethiopian Population: A Systematic Review and Meta-analysis
Sintayehu Ambachew,Aklilu Endalamaw,Abebaw Worede,Yalewayker Tegegne,Mulugeta Melku,Belete Biadgo,Mario Musella
Journal of Obesity. 2020; 2020: 1
[Pubmed] | [DOI]
5 The Association of Metabolic Syndrome and Psoriasis: A Systematic Review and Meta-Analysis of Observational Study
Saumya Choudhary,Dibyabhaba Pradhan,Anamika Pandey,Mohd. Kamran Khan,Rohit Lall,V. Ramesh,Poonam Puri,Arun K. Jain,George Thomas
Endocrine, Metabolic & Immune Disorders - Drug Targets. 2020; 20(5): 703
[Pubmed] | [DOI]
6 Factors affecting the severity of the apnea hypoapnea index: a retrospective study on 838 Egyptian patients diagnosed with obstructive sleep apnea
Ahmed Gharib,Shahira Loza
The Egyptian Journal of Bronchology. 2020; 14(1)
[Pubmed] | [DOI]
7 The association between daily naps and metabolic syndrome: Evidence from a population-based study in the Middle-East
Hamideh Ghazizadeh,Naser Mobarra,Habibollah Esmaily,Seyed Mohammad Reza Seyedi,Amin Amiri,Fariborz Rezaeitalab,Naghmeh Mokhber,Mohsen Moohebati,Mahmoud Ebrahimi,Mohammad Tayebi,Negin Behboodi,Maryam Mohammadi-Bajgiran,Samineh Hashemi,Gordon A. Ferns,Saverio Stranges,Majid Ghayour-Mobarhan,Mahmoud Reza Azarpazhooh
Sleep Health. 2020;
[Pubmed] | [DOI]
8 Incidence and risk factors for metabolic syndrome among urban, adult Sri Lankans: a prospective, 7-year community cohort, follow-up study
Shamila T. De Silva,Madunil A. Niriella,Dileepa S. Ediriweera,Dulani Kottahachchi,Anuradhani Kasturiratne,Arjuna P. de Silva,Anuradha S. Dassanayaka,Arunasalam Pathmeswaran,Rajitha Wickramasinghe,N. Kato,H. Janaka de Silva
Diabetology & Metabolic Syndrome. 2019; 11(1)
[Pubmed] | [DOI]
9 Effect of patient education on metabolic syndrome components among females in Zagazig University outpatient clinics, Egypt: An intervention study
Noha Osman Frere,Saeed Salah Abduljalil Soliman,Mohammed Adel Foda,Tayssir Kamel Eyada,Nagwa Eid Sobhy Saad
Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019; 13(3): 1897
[Pubmed] | [DOI]
10 Prevalence of metabolic syndrome and population attributable risk for cardiovascular, stroke, and coronary heart diseases as well as myocardial infarction and all-cause mortality in middle-east: Systematic review & meta-analysis
A. Ansari-Moghaddam,H.A. Adineh,I. Zareban,K.H. Kalan Farmanfarma
Obesity Medicine. 2019; 14: 100086
[Pubmed] | [DOI]
11 A new pyrano coumarin from Clausena excavata roots displaying dual inhibition against a-glucosidase and free radical
Tin Myo Thant,Nanik Siti Aminah,Alfinda Novi Kristanti,Rico Ramadhan,Preecha Phuwapraisirisan,Yoshiaki Takaya
Natural Product Research. 2019; : 1
[Pubmed] | [DOI]
12 The Effect of Soluble Fiber Supplementation on Metabolic Syndrome Profile among Newly Diagnosed Type 2 Diabetes Patients
Ayman S. Abutair,Ihab A. Naser,Amin T. Hamed
Clinical Nutrition Research. 2018; 7(1): 31
[Pubmed] | [DOI]
13 Metabolic syndrome among adolescents in Dubai, United Arab Emirates, is attributable to the high prevalence of low HDL levels: a cross-sectional study
Dalia Haroun,Rola Mechli,Razan Sahuri,Safa AlKhatib,Omar Obeid,Carla El Mallah,Lesley Wood,Khulood AlSuwaidi
BMC Public Health. 2018; 18(1)
[Pubmed] | [DOI]
14 The relationship between hypovitaminosis D and metabolic syndrome: a cross sectional study among employees of a private university in Lebanon
Rachelle Ghadieh,Jocelyne Mattar Bou Mosleh,Sibelle Al Hayek,Samar Merhi,Jessy El Hayek Fares
BMC Nutrition. 2018; 4(1)
[Pubmed] | [DOI]
15 Prevalence and trends of metabolic syndrome among adults in the asia-pacific region: a systematic review
P. Ranasinghe,Y. Mathangasinghe,R. Jayawardena,A. P. Hills,A. Misra
BMC Public Health. 2017; 17(1)
[Pubmed] | [DOI]
16 Depression, Metabolic Syndrome, and Locus of Control in Arab Americans Living in the DC Metropolitan Area: A Structural Equation Model
Nawar M. Shara,Alexander Zeymo,Zeid Abudiab,Jason G. Umans,Soleman Abu-Bader,Asqual Getaneh,Barbara V. Howard
Journal of Immigrant and Minority Health. 2017;
[Pubmed] | [DOI]
17 Systematic review and meta-analysis of the association between psoriasis and metabolic syndrome
Milton José Max Rodríguez-Zúñiga,Herney Andrés García-Perdomo
Journal of the American Academy of Dermatology. 2017; 77(4): 657
[Pubmed] | [DOI]
18 Association of sex hormones with metabolic syndrome among Egyptian males
Iman Z. Ahmed,Maram M. Mahdy,Hussein El Oraby
Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2017;
[Pubmed] | [DOI]
19 Consensus clinical recommendations for the management of plasma lipid disorders in the Middle East
Nasreen Al Sayed,Khalid Al Waili,Fatheya Alawadi,Saeed Al-Ghamdi,Wael Al Mahmeed,Fahad Al-Nouri,Mona Al Rukhaimi,Khalid Al-Rasadi,Zuhier Awan,Mohamed Farghaly,Mohamed Hassanein,Hani Sabbour,Mohammad Zubaid,Philip Barter
International Journal of Cardiology. 2016; 225: 268
[Pubmed] | [DOI]
20 Angiotensin-converting enzyme insertion/deletion polymorphism association with obesity and some related disorders in Egyptian females: a case-control observational study
Tarek K. Motawi,Olfat G. Shaker,Nancy N. Shahin,Nancy M. Ahmed
Nutrition & Metabolism. 2016; 13(1)
[Pubmed] | [DOI]
21 Growth Performance, Fasting Plasma Glucose and Lipid Profile of Sprague-Dawley Rats Fed Different Levels of Omani Halwa
Amanat Ali,Khalid M. Al-Zuhaibi,Mostafa I. Waly,D. Sankar,Eugene H. Johnson
Pakistan Journal of Nutrition. 2015; 14(8): 503
[Pubmed] | [DOI]
22 Prostate Cancer in the Arab World: A View From the Inside
Lara Hilal,Mohammad Shahait,Deborah Mukherji,Maya Charafeddine,Zein Farhat,Sally Temraz,Raja Khauli,Ali Shamseddine
Clinical Genitourinary Cancer. 2015; 13(6): 505
[Pubmed] | [DOI]
23 Prevalence of metabolic syndrome and cardiovascular risk factors among voluntary screened middle-aged and elderly Egyptians
K. M. Abd Elaziz,M. S. Gabal,O. A. Aldafrawy,H. A.-A. Abou Seif,M. F. Allam
Journal of Public Health. 2014;
[Pubmed] | [DOI]
24 The DYSlipidemia International Study (DYSIS)-Egypt: A report on the prevalence of lipid abnormalities in Egyptian patients on chronic statin treatment
Adel El Etriby,Peter Bramlage,Amany El Nashar,Philippe Brudi
The Egyptian Heart Journal. 2013; 65(3): 223
[Pubmed] | [DOI]
25 Hypertension and Obesity: Epidemiology, Mechanisms and Clinical Approach
Lauren J. Becton,Ibrahim F. Shatat,Joseph T. Flynn
The Indian Journal of Pediatrics. 2012; 79(8): 1056
[Pubmed] | [DOI]
26 Sweet Basil (Ocimum basilicum): much more than a condiment
Sandra Maria Barbalho,Flavia Maria Vasques Farinazzi Machado,Jaqueline Dos Santos Rodrigues,Tiago Henrique Pereira Da Silva,Ricardo De Alvares Goulart
TANG. 2012; 2(1): 3.1
[Pubmed] | [DOI]


    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

  In this article
    Prevalence of Me...
    Prevalence of Ob...
    Metabolic Syndro...
    International Co...

 Article Access Statistics
    PDF Downloaded468    
    Comments [Add]    
    Cited by others 26    

Recommend this journal