Open Access Research article

Prevalence of the metabolic syndrome in Pudong New Area of Shanghai using three proposed definitions among Chinese adults

Wang-hong Xu1, Xiao-nan Ruan2, Xiao-jin Fu3, Qiu-li Zhu1, Hong Zhang2, Yun Bai3, Hong-yan Wu2, Yi Zhou2, Hua Qiu2, Qiao Sun2, Qing-wu Jiang1, Li-ming Yang2, Jian-jun Gu3* and Gen-ming Zhao1*

Author Affiliations

1 Department of Epidemiology, School of Public Health, Fudan University; Key Laboratory of Public Health Safety, Ministry of Education (Fudan University), 138 Yi Xue Yuan Road, Shanghai 200032, China

2 Pudong New Area Centers for Disease Control and Prevention, 3039 Zhang Yang Road, Shanghai 200136, China

3 Health Bureau of Shanghai Pudong New Area, 820 Cheng Shan Road, Shanghai 200125, China

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BMC Public Health 2010, 10:246  doi:10.1186/1471-2458-10-246

Published: 12 May 2010



The prevalence of metabolic syndrome (MS) has been increasing in China in recent years. The aim of this study is to estimate and compare the prevalence of MS among Chinese adults in Shanghai, one of the most economic developed areas in China, using definitions proposed by World Health Organization (WHO), National Cholesterol Education Program Adult Treatment Panel (modified ATP III) and International Diabetes Federation (IDF).


This cross-sectional study included 5,584 adults at age 20-79 randomly selected from Pudong New Area of Shanghai, China, through a three-stage sampling. All participants were interviewed in-person between April and July of 2008 to collect information on demographic and lifestyle characteristics. At the interview, anthropometry and blood pressure were measured and bio-specimens were collected.


The prevalence estimates for the MS increased with age for each definition in men and women, but the estimates varied greatly between the definitions and by sex. The prevalence of the MS was higher in men (20.2%) than in women (18.7%) using WHO definition but this sex difference was reversed when using the modified ATP III (28.4% for men vs. 35.1% for women) and the IDF (15.9% for men vs. 26.7% for women) criteria. The most common metabolic disorder in this population was dyslipidaemia, regardless of the definition used. Substantial agreement, estimated using the kappa statistic, was found between the modified ATP III and IDF definition, whereas the lowest agreement was observed between the WHO and ATP III criteria.


The MS is highly prevalent among Chinese adults in Pudong New Area of Shanghai and the most prevalent component was dyslipidemia. These findings underscore the importance of prevention and control efforts for the MS in this area and the need for a unified predictive definition for the syndrome for use by clinical practitioners and public health agencies.