Metabolic syndrome: An emerging public health problem in Iranian Women: Isfahan Healthy Heart Program Nizal Sarrafzadegan a, ⁎ , Roya Kelishadi a , Abdulmehdi Baghaei a , Gholam Hussein Sadri a , Hossein Malekafzali a , Noushin Mohammadifard a , Katayoun Rabiei a , Ahmad Bahonar a , Masoumeh Sadeghi a , Jenniffer O'Laughlin b a Isfahan Cardiovascular Research Center (WHO-Collaborating Center for Research and Training in Cardiovascular Diseases Control, Prevention, and Rehabilitation for Cardiac Patients in the Eastern Mediterranean region) Isfahan University of Medical Sciences, Isfahan, Iran b Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada Received 4 June 2006; received in revised form 16 June 2007; accepted 20 October 2007 Abstract Objectives: To determine the gender-specific prevalence of the metabolic syndrome (Met S) in a representative sample of Iranian adults, and to identify some possible related lifestyle factors. Methods: As the baseline survey of a community-based interventional program entitled Isfahan Healthy Heart Program, we performed this cross-sectional study on 12,514 adults (≥ 19 years) living in urban and rural areas of 3 cities in Iran. We assessed the prevalence of the Met S (according to the ATP III criteria) as well as dietary intake (based on food frequency questionnaire) and physical activity habits of all of the participants. We also evaluated dietary intake at the micronutrient level by using a one-day food record in a sub-sample of 2000 participants. Results: The age-adjusted prevalence of Met S was 23.3%, with a higher prevalence in women compared to men (35.1% vs. 10.7%, P b 0.05) and in urban residents compared to rural residents (24.2% vs. 19.5%, P b 0.05). In all age groups and in both urban and rural areas, the Met S affected a significantly larger number of women than men. Among women, abdominal obesity (71.7%) was more prevalent followed by low HDL-C (60.9%) and hypertriglyceridemia (56.6%), whereas among men, the most frequent components were hypertriglyceridemia (49.1%) and low HDL-C (35.1%), respectively. Abdominal obesity was nearly six times as prevalent in women as in men (71.7% vs. 12%, P b 0.05) and had a significant association with metabolic disorders even after adjustment for age, sex and the living area. In general, dietary intake had no effect on the prevalence of Met S. The prevalence of Met S in subjects with a sedentary lifestyle was significantly higher than in active subjects of both genders (25.6% vs. 14.4%, respectively, P b 0.05). Conclusion: The Met S is highly prevalent in the Iranian population, notably in women living in urban areas. Abdominal obesity and dyslipidemia characterize this syndrome. Implementing community-based strategies for lifestyle change is of great significance. © 2007 Elsevier Ireland Ltd. All rights reserved. Keywords: Metabolic syndrome; Gender-specific prevalence; Lifestyle; Living area 1. Introduction The term metabolic syndrome (Met S) refers to a clustering of risk factors; it is a key feature of the patho- genesis of type 2 diabetes and the progression of many degenerative processes including atherosclerosis. It is widely agreed that the Met S is a growing and pressing problem in developing countries. The prevalence of non-communicable International Journal of Cardiology xx (2008) xxx – xxx IJCA-10463; No of Pages 7 www.elsevier.com/locate/ijcard ⁎ Corresponding author. Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, P.O. Box: 81465-1148, Isfahan, Iran. Tel.: +98 311 3377888 9; fax: +98 311 3373435. E-mail address: crc@mui.ac.ir (N. Sarrafzadegan). URL's: http://www.crc.mui.ac.ir, http://www.ihhp.ir (N. Sarrafzadegan). 0167-5273/$ - see front matter © 2007 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2007.10.049 ARTICLE IN PRESS Please cite this article as: Sarrafzadegan N, et al, Metabolic syndrome: An emerging public health problem in Iranian Women: Isfahan Healthy Heart Program, Int J Cardiol (2008), doi:10.1016/j.ijcard.2007.10.049