TMSS Medical College Journal

Metabolic syndrome is a cluster of risk factors that increases the chance for coronary heart disease (CHD) and other health problems such as diabetes and stroke. Metabolic syndrome (MS) now has become a global epidemic. Both developed and developing countries are increasingly vulnerable to the worldwide epidemic of metabolic syndrome, which affects all segments of the population specially those who lead sedentary life. Various medical problems like, cardiovascular diseases, type-2 diabetes mellitus etc. are associated with metabolic syndrome. Recently, we have witnessed a dramatic rise of the prevalence of metabolic syndrome among the people who leads sedentary lives. Among them bankers are a most important group because of their profession and social responsibilities. Increasing trend of metabolic syndrome among them is of serious concern in the context of healthy bankers and development of our country. To provide different types of preventive measures, we should know the magnitude of the problem by finding out the prevalence of metabolic syndrome among Bangladeshi bankers. In this study our aim was to see the prevalence of metabolic syndrome among the bankers of Bangladesh and to evaluate two anthropometric indices like, WHR (waist-hip ratio), WHtR (waist-height ratio) and two biochemical indices such as Ttriacylglycerol, HDL-C (high density lipoprotein) for their predictive value of metabolic syndrome. With this aim 500 Bangladeshi bankers, age ranging from 25-55 years, of both sexes at least junior bank officer from government and private bank were enrolled and the study was carried out in the Department of Biochemistry, BSMMU, Shahbag, Dhaka, Bangladesh. The study subjects were selected by convenient and purposive sampling technique. The study was a cross sectional study. Foreigner bankers who are working in Bangladesh, pregnant female bankers, known endocrine disorders (like polycystic ovary syndrome, Cushing syndrome, hypothyroidism), antidepressant and anticonvulsant drug users and bankers aged more than 55 years were excluded from this study. Study subjects were categorized on the basis of sex, age groups, government and private sector. Presence of metabolic syndrome was diagnosed by modified NCEP ATP III criteria. Prevalence of metabolic syndrome was measured at 95% CI. According to set criteria, prevalence of metabolic syndrome was found 43.4% of total study subjects, among them 42.4% were male and 52.0% were female. Prevalence of metabolic syndrome in age group 25-40 years were 29.6% of male, 41.7% of female and in age group 40-55 years were 55.1% of male and 55.3% of female. It was found (49.8%) among government bankers and (36.3%) among private bankers. Proportion test was done to compare the prevalence of metabolic syndrome between male & female, government & private bankers and between age groups. Statistical significance was set at p<0.05. In our study it was found that the prevalence of metabolic syndrome was higher in female bankers in total population. In total subjects and male bankers, significantly higher prevalence of MS found in 40-55yrs age group than 25-40yrs, but in female statistically no significant difference. Prevalence increases according to the increase of age. There is significantly higher prevalence of metabolic syndrome found in government than private bankers. In our study, we have calculated SEN, SPE, PPV, NPV, LR’, LR" & Accuracy of WHR, WHtR, TAG & HDL-C as predictors of MS. In our study, the most sensitive predictor for male and female was found WHR (92.7% & 100.0%). On the other hand most specific predictor for male was HDL-C (72.2%) and female was TAG (100.0%). ROC curves of WHR, WHtR, TAG and HDL-C were produced to see the area under the curve (AUC) and to evaluate their predictive value of metabolic syndrome. In our study all those indices were found good for their predictive value of metabolic syndrome. We calculated optimal cut of point (OCP) of WHR, WHtR, TAG and HDL-C as predictor for detection of MS in male, female and total study subjects on the basis of Youden’s Index (Y-index). We found OCP of ‘WHIR was 0.523 and that of TAG was 149.0mg/dl in total study subjects. OCP of WHR was found 0.934 in male, 0.889 in female and that of HDL-C was 39.0mg/dl in male, 44.0mg/dl in female respectively. The findings of our study agreed the previous observations of increased prevalence of metabolic syndrome.

Metabolic syndrome (MS) is a cluster of widely prevalent multi-factorial medical disorders that presents in a distinct, albeit heterogeneous phenotype and increases the risk of developing cardiovascular disease and diabetes (Gogia and Agarwal, 2006). In 1977, Haller used the term “metabolic syndrome” (Haller, 1977). It is also known as syndrome X or insulin resistance syndrome (Reaven, 1988). In 2001, National Cholesterol Education Program Adult Treatment Panel III (NCEP: ATP III) accepted the term “metabolic syndrome” (NCEP: ATP III, 2001). The first formal definition of the MS was put forward in 1998 by the World Health Organization (WHO). This report was finalized in 1999 for individual having insulin resistance with any two of hypertension, dyslipidemia, central obesity and high urinary albumin excretion rate or high urinary albumin:creatinine ratio (Grundy et al. 2004).