Robert Wong, MD, MS Division of Gastroenterology and Hepatology Veterans Affairs Palo Alto Healthcare System Stanford University School of Medicine

Demographic Disparities in Increasing Prevalence of Metabolic Syndrome Interview with:

Robert Wong, MD, MS Division of Gastroenterology and Hepatology Veterans Affairs Palo Alto Healthcare System Stanford University School of Medicine

Dr. Wong

Robert Wong, MD, MS
Division of Gastroenterology and Hepatology
Veterans Affairs Palo Alto Healthcare System
Stanford University School of Medicine What is the background for this study?

Response: Prior to this study, we already knew that obesity and metabolic syndrome were major public health issues in the U.S.  A previous analyses by our team which analyzed data through 2012 observed than one in three adults in the U.S. have metabolic syndrome.  The aim of our current study was to evaluate more recent trends in the prevalence of metabolic syndrome and to identify whether certain groups are at higher risk of having metabolic syndrome. What are the main findings?

Response: The current study adds several important items to our understand of metabolic syndrome epidemiology in the U.S.

Firstly, the prevalence of metabolic syndrome has continued to increase, and in the most recent time period studied (2015-2016), 36.9% of adults have metabolic syndrome.

We were also able to identify certain groups at significantly higher risk of metabolic syndrome, including individuals age 60 years and over who had a prevalence of 50.4% in 2015-2016 and Hispanic populations, where we observed a prevalence of 40.4% in 2015-2016.  The risk factors in combination seem to exert even higher risk, such that Hispanic individuals age 60 years and over were observed to have a metabolic syndrome prevalence of 57.3% overall.

Another interesting observation is the increasing prevalence of metabolic syndrome among young individuals.  In our study metabolic syndrome prevalence among those age 20-29 years old increased significantly, and in 2015-2016 more than 20% had evidence of metabolic syndrome.

These findings are critical for patients and providers to be aware.  Metabolic syndrome is a systemic disease and is associated with a host of metabolic and cardiovascular complications, which increases morbidity and mortality.  Our results emphasize the importance to raise greater awareness of this public health issue, and highlight the need for patients and providers to work together to proactively and effectively screen and optimize diseases associated with metabolic syndrome such as obesity, hypertension, insulin resistance, and dyslipidemia. What should readers take away from your report?

Response: The take home message that our study aims to highlight is raising greater awareness of metabolic syndrome for providers across specialties.  Metabolic disease is a major public health issue and is associated with significantly morbiditiy and mortality.  Equally alarming is the increasing prevalence seen among young adults.  Earlier recognition of metabolic disease risk factors is needed to implement targeted interventions to prevent downstream complications.  From a public health perspective, more research and work is needed to target the epidemic of high calorie food and high calorie density consumption that is contributing to obesity in the U.S., as well as the need to promote a more active lifestyle. What recommendations do you have for future research as a result of this study?

Response: Metabolic syndrome is a very complex disease state that we are continually understanding more about the pathogenesis.  At its core, metabolic syndrome is a result of metabolic diseases that develop, and this is reflected in its definition that includes presence of diseases such as hypertension, central obesity, insulin resistance, and elevated lipids and triglycerides.  Certainly, some of this is related to aging, as older individuals develop more of the previously mentioned co-morbidities.  Another component likely reflects genetic predisposition, as many individuals may have a very strong family history of these metabolic diseases which in turn contributes to higher risk of developing these metabolic co-morbidities themselves.  Another important component reflects lifestyle and dietary choices.  Recent studies have reported on the increasing prevalence of obesity in the U.S., as well as an alarming trend of obesity among adolescents and young adults.  High calorie dietary choices combined with a more sedentary lifestyle are major factors that continued to the continued high prevalence and increasing trend of metabolic syndrome. In some ways, these risk factors are modifiable, either through healthier lifestyle and dietary choices or improved screening for and optimization of metabolic co-morbidities.  However, the etiology and impact of metabolic syndrome, especially it’s interaction with underlying genetics as well as other co-morbidities deserves greater research.

Disclosures include: Advisory board, research grant, speaker’s bureau for Gilead Sciences


Hirode G, Wong RJ. Trends in the Prevalence of Metabolic Syndrome in the United States, 2011-2016. JAMA. 2020;323(24):2526–2528. doi:10.1001/jama.2020.4501


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Last Updated on June 26, 2020 by Marie Benz MD FAAD