The epidemiology of clustered risk factors compatible with Metabolic Syndrome in Hawai'i

Hirokawa, Robert
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Thesis (D.P.H.)--University of Hawaii at Manoa, 2008.
Metabolic Syndrome (MetS) refers to the clustering of various cardiometabolic risk factors, including glucose intolerance, abdominal obesity, dyslipidemia and elevated blood pressure. Over the past two decades the world has experienced a sharp increase in the number of people with MetS. It is estimated that around 20--25 percent of the world's adult population now have metabolic syndrome.
Poisson regression analysis showed that race/ethnicity was an independent risk factor for having 3--4 MetS risk factors when controlling for age, education, gender, poverty level, having healthcare coverage, and having a personal doctor.
This study had three main aims: (1) to describe the epidemiology of obesity in Hawaii using standard and proposed ethnic specific BMI definitions of obesity, (2) to describe the epidemiology of clustered risk factors compatible with MetS among Hawaii's population using standard and proposed ethnic-specific BMI definitions of obesity, and to (3) to estimate crude and adjusted prevalence ratios for clustered risk factors compatible with MetS.
This study provides a glimpse into the future burden Hawaii may be faced with as the prevalence of obesity and its associated conditions continue to rise.
This study used the Behavioral Risk Factor Surveillance System (2001--2005) to examine the prevalence of weight status (obesity) and MetS in Hawaii. The findings confirmed what is already known---obesity rates are high and disparities exist. However, when ethnic specific case definitions of weight status were applied, a dramatic shift in the distribution of obesity emerged. For example, when using World Health Organization (WHO) BMI thresholds, the major Asian groups had obesity rates in the 10% range. Applying ethnic specific BMI thresholds, obesity prevalence among Asians increased into the mid 40% range.
When using WHO BMI definitions of obesity, the prevalence of 3--4 MetS risk factors ranged from a low of 2.7% ("Other Asians") to a high of 18.8% ("Other Pacific Islanders"), with a mean of 8.3%. When using ethnic specific definitions of obesity, the prevalence of 3--4 MetS risk factors ranged from a low of 3.6% (Blacks) to a high of 17.8% ("Other Pacific Islanders"), with a mean of 10.5%.
Includes bibliographical references (leaves xxx-xxx).
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85 leaves, bound 29 cm
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Theses for the degree of Doctor of Public Health (University of Hawaii at Manoa) ; no. 91
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