**3. Pathophysiological development of metabolic syndrome**

Many different factors such as genetics, lifestyle (diet and physical activity), obesity and insulin resistance have been hypothesized to play a role in the development of MetSy [8, 11, 12]. Visceral adiposity as a result of a high caloric intake has been demonstrated to be a primary trigger and a major causative factor for the pathogenesis in MetSy [13–15]. A metanalysis conducted by Ryckman et al. [16]


#### *Lifestyle and Epidemiology - The Double Burden of Poverty and Cardiovascular Diseases...*

*6 Abaxis – Piccolo® Lipid Panel Plus Reagent Disc. 7*

*American Diabetes Association. 8 Mayo Clinic.*

**Table 2.** *Reference ranges for clinical and biochemical measurements.*

found that the presence of a single element of metabolic syndrome could contribute to the development of metabolic syndrome, and that diabetes alone will later contribute to the development of hypertension. Obesity appears more common in

**195**

[22–24].

*Metabolic Syndrome in Reproductive Health: Urgent Call for Screening*

females and this is attributed to the fact that most women gain weight outside the

Due to the aging population, global increase in obesity and sedentary lifestyles, the prevalence of MetSy is increasing throughout the world and it has become an epidemic of the 21st century [18]. Prevalence rates vary widely due to the criteria used, age of the population, gender, ethnic group, prevalence of obesity in the background population, and environment. The incidence of MetSY often parallels the incidence of obesity and incidence of T2DM. The global prevalence of MetSy has be estimated to be about one quarter of the World population [19]. The prevalence of MetSy is 0–50% or more in African populations, commoner in females and

Screening can include individuals with pre-symptomatic or unrecognized symptomatic disease [21]. Several studies have shown the importance of screening

Health-screening programmes have been effectively used to pinpoint publichealth challenges [25–40], and many countries have implemented nationwide health screening and intervention programmes that specifically target MetSy [41]. The first Framingham Risk Score is a gender-specific score that identifies patients at risk of developing cardiovascular complications within a 10-year period. It factors in age, sex, LDL cholesterol, HDL cholesterol, smoking, blood pressure and also whether the patient is on treatment or not for hypertension, lipidaemia and diabetes, and smoking [42]. Artigao-Rodenas et al. [42] applied the Framingham Risk Score in a prospective cohort study of four years in Spain and found that the model had a good predictive value, with negative predictive values in both sexes, a specificity of 85.6% in women and sensitivity of 79.1% in men in a population with high risk of cardiovascular disease. The model had a significant cumulative probability

of individual survival by tertiles in both sexes with a p value <0.001.

**and mid-upper arm circumference(MUA)**

**6. Obesity screening anthropometric indices: body mass index (BMI)** 

BMI is currently the metric measure used to determine categories of bodyweight in adults (**Table 3**). Other methods and techniques of estimating body fat and bodyfat distribution includes measurements of the waist circumference (WC), waist-hip ratio, underwater weighing, bioelectrical impedance analysis, skin-fold thickness and imaging techniques such as ultrasound, computed tomography, and magnetic resonance imaging with the later giving the most accurate estimates of body composition [44]. The problem of using MUAC is that there is no consensus on its cut-offs internationally [45]. Waist circumference has likewise been shown to estimate body fat, but is a fairly better guide to cardiometabolic disease risks as it identifies people with relatively low BMI but with increased intra-abdominal fat accumulation [46]. In most studies which have measured estimated total body fat by a reference method, BMI was found not to be a strong predictor of body fat [47] and therefore other methods should be developed to better classify individuals at risk of

*DOI: http://dx.doi.org/10.5772/intechopen.95971*

recommended levels during pregnancy [17].

**4. Global epidemiology of metabolic syndrome**

increases with age and urban housing (Okafor, 2012) [20].

**5. Screening for MetSy in the general public**

*Lifestyle and Epidemiology - The Double Burden of Poverty and Cardiovascular Diseases...*

**Analyte Range Classification**

VLDL55 0.1-1.7 Normal / near optimal

(mmol/L) < 5.2 Desirable

5.2–6.1 Borderline high > 6.1 High

< 2.6 Optimal 2.6–3.3 Near optimal 3.4–4.1 Borderline high 4.2–4.9 High > 4.9 Very high

< 3.5 Optimal (male) < 3.4 Optimal (female) > 5.0 Above average risk (male) > 4.4 Above average risk (female)

> 0.77 High

< 3.4 Optimal 3.4–4.1 Near optimal 4.2–4.9 Borderline high 5.0–5.7 High > 5.7 Very high

< 1.69 Desirable 1.69–2.25 Borderline high 2.26–5.63 High > 5.63 Very high

< 5.6 Normal (fasting) < 7.8 Normal (non-fasting) 4.1–6.6 Reference interval (fasting)

< 2, > 30 Critical

> 1.53 Less than average risk 1.03–1.53 Average risk (male) 1.29–1.53 Average risk (female) < 1.03 Increased risk (male) < 1.29 Increased risk (female)

Total Cholesterol1

HDL1,2 (mmol/L)

LDL1 (mmol/L)

CHOL/HDL3,4 (mmol/L)

Non-HDL1,2 (mmol/L)

Triglycerides1 (mmol/L)

Glucose6,7,8 (mmol/L)

*National Cholesterol Education Program ATP III.*

*Abaxis – Piccolo® Lipid Panel Plus Reagent Disc.*

*Reference ranges for clinical and biochemical measurements.*

*Lab Tests Online - Lipid Panel.*

*Harvard Medical Health Guide.*

*American Diabetes Association.*

*American Heart Association.*

*Lab Tests Online – VLDL.*

found that the presence of a single element of metabolic syndrome could contribute to the development of metabolic syndrome, and that diabetes alone will later contribute to the development of hypertension. Obesity appears more common in

**194**

*1*

*2*

*3*

*4*

*5*

*6*

*7*

*8*

**Table 2.**

*Mayo Clinic.*

females and this is attributed to the fact that most women gain weight outside the recommended levels during pregnancy [17].
