Rising clustering of metabolic risk factors and behavioral-metabolic profiles in Viet Nam, 2015-2021: repeated cross-sectional surveys.

Abstract

Objectives: Evidence on the burden and clustering of metabolic non-communicable disease risks and on data-driven risk profiles remains limited. This study assessed trends in the clustering of metabolic risk factors in Viet Nam from 2015 to 2021 and identified behavioral-metabolic profiles in 2021.

Methods: A repeated cross-sectional design was used, using national STEPS data from 2015 (n = 3,074) and 2021 (n = 3,712), both of which included participants who completed all survey components. Behavioral risk factors (smoking, alcohol use, physical inactivity, and low fruit and vegetable intake) and metabolic risk factors (elevated blood pressure, fasting glucose, body mass index (BMI), and total cholesterol) were defined using Asian-calibrated cutoffs. Clustering was defined as the co-occurrence of two or more metabolic risk factors within an individual. Weighted analyses estimated prevalence and clustering, and latent class analysis (LCA) identified behavioral-metabolic profiles.

Results: All metabolic risks increased between 2015 and 2021, most sharply for raised fasting glucose (12.0% → 37.7%). This increase was a major contributor to intensified clustering, with the prevalence of ≥2 risk factors increasing from 27.6% to 46.6% and ≥3 risk factors increasing from 8.7% to 20.1%. LCA revealed three profiles: "Health-Conscious" (38.1%, low behavioral and metabolic risks), "Metabolic Risk-Aware" (34.6%, low behavioral but high metabolic risks, linked to older age), and "High Behavioral Risk with Moderate Metabolic Comorbidity" (27.3%, characterized by high smoking and alcohol use together with moderate metabolic abnormalities, concentrated among socioeconomically disadvantaged men).

Conclusion: Metabolic risks in Viet Nam increased markedly between 2015 and 2021, with elevated glucose levels playing an important role in multi-risk clustering. These distinct profiles underscore the need for integrated, multi-risk screening and management in primary care, especially targeting older adults and socioeconomically disadvantaged men.