Effects of smoking, alcohol, exercise, level of education, and family history on the metabolic syndrome in Korean adults

Jung, Chan Hee; Park, Jeong Sik; Lee, Won Young; Kim, Sun Woo

Abstract

BACKGROUND: People with the metabolic syndrome are at increased risk for cardiovascular mortality. Metabolic syndrome is caused by interplay between genetic and many environmental factors. Although several environmental factors have diverse effect on the development of metabolic syndrome, few studies have examined their relation in Koreans. This study was performed to estimate the effects of smoking, alcohol consumption, exercise, education level and family history on the components of metabolic syndrome in Korean adults and to observe the relative risk of developing metabolic syndrome defined by NCEP-ATP III according to these factors.
METHODS
This study was performed in 4341 subjects (2059 men, 2282 women, mean age 42.3+/-10.4). We gathered the smoking, alcohol drinking, exercise, family history and education level by self-administered questionnaire at the health promotion center. Height, weight, waist circumference, blood pressure were examined. Fasting serum triglyceride, high density lipoprotein cholesterol, fasting glucose were measured.
RESULTS
Multivariate-adjusted odds ratio of hypertriglyceridemia was 1.4 (95% CI 1.0~1.8) and low HDL-C (high density lipoprotein cholesterol) was 1.9 (95% CI 1.3~2.6) in subjects who smoked more than 20 PYS compared to nonsmokers. Also relative risk of developing metabolic syndrome in smokers (more than 20 PYS) was 1.9 (95% CI 1.1~3.7) compared to nonsmokers. Alcohol consumption had a significant protective effect against low HDL-C in all categories compared to nondrinkers (adjusted OR 0.6~0.2). In people with lack of exercise, the odds ratio of high waist circumference was 4.1 (95% CI 1.31~8.6), high triglyceride was 1.3 (95% CI 1.0~1.8), low HDL-C was 1.5 (95% CI 1.5~2.0) when compared to subjects with regular exercise. Relative risk for metabolic syndrome was 1.7 (95% CI 0.9~2.8). The adjusted odds ratio of high blood pressure was 1.3 (95% CI 1.1~1.6) and high fasting glucose was 1.7 (95% CI 1.1~2.5) in subjects with family history compared to subjects without family history. Relative risk for the metabolic syndrome was 1.5 (95% CI 1.1~2.1) in subjects with family history. Relative risk for the presence of the metabolic syndrome in subjects with lowest education level was 2.0 (95% CI 1.2~3.4) when compared to subjects with the highest education level. Significant associations were found between low education and high waist circumference (OR 4.5, 95% CI 1.5~14.0) and low HDL-C (OR 1.2, 95% CI 1.0~1.4) and high blood pressure (OR 2.1, 95% CI 1.6~2.9).
CONCLUSION
Smoking was associated with dyslipidemia. Alcohol consumption increased HDL-C and was associated with abdominal obesity. Lack of exercise was associated with obesity and dyslipidemia. Family history was associated with hypertension and diabetes. Low education level was strongly associated with hypertension and abdominal obesity. Since subjects with low education level and family history were associated with increased risk for metabolic syndrome and thus developing cardiovascular disease, particular attention should be paid in these subjects.