A Population Based Multi-Site Study Of Metabolic Syndrome among immigrant Asian Indians in the United States and Indians in India

India has over a billion people, and Asian Indians are one of the largest immigrant Asian groups to the United States in recent years. However cross-cultural study that examines metabolic syndrome (MetS) in rural Indians, urban Indians, and Indian Americans is lacking. Hence this study examined the prevalence of MetS using a community-based study design. MetS was diagnosed according to the modified NCEP, ATP III definition, and the IDF definition and comparison made between the three groups. Sample comprised of 599 rural Indians in Tamilnadu, 508 urban Indians in New Delhi and 1038 migrant Asian Indians in the US (Houston, Phoenix, Washington DC, Boston, Edison, Parsippany, and San Diego). Data was collected using telephone interviews (US) and face-to-face interviews (India). Mean age was 42 years in India and 47 years in the US. The prevalence of MetS was higher among the immigrants (26.9%, 32.7% and 38.2% by NCEP/ATP III, modified NCEP/ATP III definition, and the IDF definition respectively) as compared to the urban Indians (28%, 30.8% and 39.2%) and rural Indians (6.1%, 8.6%, and 10.5%); rates were twice for women in urban and rural areas than men. There were significant gender differences in several components of metabolic syndrome (serum triglycerides, blood pressure, cholesterol, and abdominal obesity) with females having a higher frequency of abdominal obesity (especially among immigrants) and low HDL-C levels, while males had a higher frequency of hypertriglyceridemia and hypertension. It is possible that low levels of HDL-C primarily determine higher prevalence of the metabolic syndrome in women.