Metabolic syndrome among Sri Lankan adults: prevalence, patterns and correlates

Metabolic Syndrome (also known as cardio-metabolic syndrome, syndrome X and insulin resistance syndrome) is a name given to a group of risk factors when occurring together increases the risk for Coronary Artery Disease (CAD), stroke, and type-2 diabetes [1,2]. These risk factors include; obesity, dysglycaemia, dyslipidaemia and hypertension [3]. Insulin resistance plays a central role in the pathophysiology of Metabolic Syndrome (MS). Evidence indicates that MS begins with excess central adiposity [4]. In the genetically predisposed individuals, defects in insulin secretion follows, leading to impaired fasting glucose (IFG) and/or impaired glucose tolerance/glucose intolerance (IGT) [5]. Metabolic syndrome appears to have a component of heritability, which suggests a genetic basis [6]. Patients with rare single-gene disorders express the clusters of metabolic abnormalities associated with MS [6]. However, the association is complex and unresolved issues such as the role of gene-environment interactions, ethnicity, and gender in pathogenesis need to be further explored.South Asians represent one-fifth of the global population and South Asian immigrants are the fastest growing immigrant population in many developed countries in the world. Studies have shown higher rates of CAD, insulin resistance and MS among South Asian immigrants living in developed countries [7]. The prevalence of CAD in South Asian immigrants was three times higher, even after adjustment for all conventional risk factors [8]. It is predicted that more than one-half of the world's CAD burden will be borne by people from the Indian subcontinent in coming decades [9]. Furthermore, evidence has shown that MS is twice more common amongst South Asian immigrants living in the US compared to the native Caucasian population [10]. Several studies have hinted at a possible genetic cause for this high prevalence of MS in South Asians [11]. The most recent surveys from Pakistan and India show that the prevalen