Metabolic Syndrome (MetS) is a cluster of interrelated metabolic abnormalities that include central obesity, elevated blood pressure, dyslipidemia (hypertriglyceridemia and low high-density lipoprotein cholesterol), and impaired glucose tolerance or insulin resistance. These factors synergistically increase the risk of developing cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), and all-cause mortality [1,2].

In recent decades, the global burden of MetS has escalated markedly, largely driven by increasing urbanization, physical inactivity, unhealthy dietary habits, and a growing prevalence of obesity [3]. According to the Global Burden of Disease Study 2010, modifiable lifestyle risk factors now account for a substantial proportion of morbidity and mortality across both developed and developing nations [3]. This epidemiological shift reflects the rising contribution of non-communicable diseases (NCDs) to global health outcomes.

In India, the estimated prevalence of MetS ranges between 25% and 35% in urban populations and is moderately lower in rural settings, although regional variations persist due to differences in ethnicity, lifestyle behaviors, and diagnostic criteria applied [4,5]. Studies from various parts of India, including Himachal Pradesh, highlight the growing impact of MetS even among newly diagnosed hypertensive patients, underscoring its emerging role as a major public health challenge [6].

Early detection of MetS is critical, as it provides an opportunity for timely intervention through lifestyle modification and pharmacological measures to prevent long-term complications. The modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guidelines are widely accepted and used for diagnosing MetS, particularly in low-resource clinical settings [4].

Despite its clinical relevance, there remains a scarcity of updated regional data on the prevalence and contributing risk factors of MetS in various tertiary care settings in India. This study was therefore conducted to assess the prevalence of MetS and to explore its associated risk factors among adult patients attending a tertiary care hospital. The findings are expected to aid in formulating targeted prevention and management strategies in high-risk populations.

Study Design and Setting:

This was a hospital-based, cross-sectional study conducted at the Department of General Medicine, Government Medical College (GMC), Rajanna Sircilla, Telangana. The study was carried out over a period of nine months, from May 2024 to January 2025.

Study Population:

The study included adult patients aged 18 years and above attending the outpatient and inpatient departments of GMC Rajanna Sircilla during the study period. Participants who gave informed written consent were recruited consecutively. Patients with previously diagnosed chronic illnesses such as coronary artery disease, stroke, or chronic kidney disease were excluded to avoid confounding.

Sample Size:

A total of 100 adult participants were enrolled in the study using convenience sampling.

Data Collection:

A structured data collection form was used to record demographic details, clinical history, anthropometric measurements, and laboratory findings. Measurements included weight, height, waist circumference, and blood pressure. Fasting blood samples were collected to assess fasting plasma glucose, triglycerides, and HDL cholesterol.

Diagnostic Criteria:

Metabolic Syndrome was diagnosed using the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Participants were considered to have MetS if they met three or more of the following five criteria:

Waist circumference >102 cm in men or >88 cm in women

Serum triglycerides ≥150 mg/dL

HDL cholesterol <40 mg/dL in men or <50 mg/dL in women

Blood pressure ≥130/85 mmHg or on antihypertensive medication

Fasting plasma glucose ≥100 mg/dL or known diabetes mellitus

Statistical Analysis:

Data were entered into Microsoft Excel and analyzed using SPSS version 25.0. Descriptive statistics were presented as frequencies, percentages, means, and standard deviations. Chi-square test and t-test were used for bivariate analysis. Multivariate logistic regression was performed to identify independent risk factors for MetS. A p-value of <0.05 was considered statistically significant.

A total of 100 adult participants were enrolled in the study. Among them, 58 (58%) were males and 42 (42%) were females. The mean age of the participants was 46.3 ± 11.2 years, with an age range of 25 to 70 years (Table 1).

Table 1: Demographic Characteristics of Study Participants (N = 100)

The overall prevalence of Metabolic Syndrome (MetS) based on the modified NCEP ATP III criteria was found to be 41%. Among the individual components of MetS, elevated blood pressure was the most prevalent (60%), followed by abdominal obesity (52%), elevated triglycerides (48%), elevated fasting blood glucose (46%), and low HDL cholesterol (44%) (Table 2).

Table 2: Prevalence of Metabolic Syndrome Components

Gender-wise analysis showed that the prevalence of MetS was higher among females (45.2%) than males (37.9%), although the difference was not statistically significant (Table 3).

Table 3: Gender-wise Prevalence of Metabolic Syndrome

Multivariate logistic regression analysis identified several significant risk factors associated with MetS. Individuals aged ≥45 years had 2.6 times higher odds of developing MetS (OR: 2.6; 95% CI: 1.2–5.5; p = 0.01). Participants with a BMI ≥25 kg/m² were at even higher risk (OR: 3.4; 95% CI: 1.5–7.6; p = 0.002). A sedentary lifestyle was also significantly associated with the presence of MetS (OR: 2.1; 95% CI: 1.0–4.4; p = 0.04) (Table 4).

Table 4: Risk Factors Associated with Metabolic Syndrome (Multivariate Logistic Regression Analysis)

Among those diagnosed with MetS, 78% had exactly three components, while 22% had four or more components (Table 5).

Table 5: Distribution of Metabolic Syndrome Components among Affected Participants

Furthermore, the prevalence of MetS was higher among smokers (51.7%) compared to non-smokers (37.2%), but this difference did not reach statistical significance (p = 0.08) (Table 6).

Table 6: Smoking Status and MetS Prevalence

This study found that the prevalence of Metabolic Syndrome (MetS) among adults attending Government Medical College, Rajanna Sircilla, was 41%, highlighting a significant burden of cardiometabolic risk factors in this population. This finding aligns with previous reports from India and other developing nations, where the prevalence of MetS among adults ranges between 25% and 45% depending on population characteristics and diagnostic criteria used [7,8].

Among the components of MetS, elevated blood pressure (60%) and abdominal obesity (52%) were the most commonly observed, followed by elevated triglycerides (48%). These trends are consistent with previous studies conducted in African and Asian populations, where central obesity and hypertension were frequently the dominant metabolic disturbances [9,10]. For example, Lu et al. noted similar findings among Chinese diabetic patients over 30 years, emphasizing the universality of these risk patterns in populations undergoing lifestyle transitions [10].

Gender-wise analysis in our study showed a higher prevalence of MetS in females (45.2%) than males (37.9%), though not statistically significant. This is in agreement with the findings of Ezeala et al., who reported a female predominance in MetS prevalence among hypertensive Nigerian adults [11]. Hormonal changes, particularly during menopause, in conjunction with sedentary behavior and dietary practices, may explain this disparity.

Multivariate analysis identified age ≥45 years, BMI ≥25 kg/m², and sedentary lifestyle as significant risk factors for MetS. These associations have been previously established in both African and South Asian settings, supporting the role of age-related metabolic changes and urbanized lifestyles in disease expression [12,13]. For instance, Getenet et al. found similar risk patterns in Ethiopian psychiatric patients, despite their differing clinical backgrounds [12].

Although smoking showed a higher prevalence of MetS (51.7%) in our study, it was not statistically significant (p = 0.08). Nonetheless, prior evidence confirms smoking as a contributor to insulin resistance, dyslipidemia, and vascular inflammation [14].

Our findings underscore the urgent need for comprehensive lifestyle modification programs, including weight control, dietary changes, and regular physical activity. Public health measures focusing on early screening and patient education in both hospital and community settings are critical. The high prevalence of modifiable risk factors presents an opportunity for targeted interventions that can significantly reduce the burden of cardiovascular disease and type 2 diabetes.

This study was limited by its single-center design and modest sample size, which may affect generalizability. Moreover, the cross-sectional nature of the study precludes the establishment of causal relationships. Larger multicenter studies with longitudinal follow-up are warranted to confirm these findings and evaluate the long-term outcomes associated with MetS.

The present study highlights a significant prevalence of Metabolic Syndrome (41%) among adults attending Government Medical College, Rajanna Sircilla. Elevated blood pressure, abdominal obesity, and dyslipidemia emerged as the most common components. Advancing age, higher body mass index, and sedentary lifestyle were identified as major risk factors. These findings underscore the need for routine screening and early identification of high-risk individuals in primary and tertiary healthcare settings. Preventive strategies such as lifestyle modifications, weight reduction, dietary counseling, and physical activity promotion must be prioritized to curb the growing burden of MetS. Public health policies should integrate MetS surveillance and management to reduce long-term cardiovascular and metabolic complications.

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