Yuan Lu ScD , Xumin Li MS , Yuntian Liu MPH , César Caraballo MD , Daisy Massey BA , Shiwani Mahajan MD, MHS , Erica Spatz MD, MHS , Jeph Herrin PhD , Harlan M. Krumholz MD, SM
{"title":"1999-2018年不同种族/民族代谢综合征流行趋势、治疗和个体成分关系","authors":"Yuan Lu ScD , Xumin Li MS , Yuntian Liu MPH , César Caraballo MD , Daisy Massey BA , Shiwani Mahajan MD, MHS , Erica Spatz MD, MHS , Jeph Herrin PhD , Harlan M. Krumholz MD, SM","doi":"10.1016/j.jacadv.2025.101785","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Nationally representative data on recent trends in racial/ethnic differences in metabolic syndrome (MetS) prevalence and treatment are sparse.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to examine 20-year trends in the prevalence, treatment, and interrelationships of MetS and its individual components among U.S. adults, overall and by race/ethnicity.</div></div><div><h3>Methods</h3><div>We evaluated trends from 1999 to 2018 in 20,397 adults using data from the National Health and Nutrition Examination Survey. Age-standardized prevalence estimates were calculated for MetS, its components, and related prescription drug use. Trends were assessed using weighted linear regression, and racial/ethnic disparities were examined using <em>t</em>-tests.</div></div><div><h3>Results</h3><div>The mean age was 47.5 (47.4-47.6) years; 51.3% were female; 77.9%, 12.8%, and 9.4% were White, Black, and Hispanic, respectively. MetS prevalence increased significantly from 1999 to 2018 across all groups (<em>P</em> < 0.001). Among MetS components, waist circumference and fasting glucose increased across all groups, while triglycerides increased only among Black individuals. Lipid-lowering medication use increased (<em>P</em> < 0.001), but racial/ethnic disparities persisted. Compared to White individuals, Hispanic individuals had lower antihypertensive and lipid-lowering medication use (<em>P</em> < 0.01). Despite increased prescriptions, <65% of eligible individuals received lipid-lowering therapy, and <35% received antihyperglycemic therapy, highlighting substantial treatment gaps. Racial/ethnic differences in MetS component relationships were observed: blood pressure played a larger role in Black individuals, while fasting glucose was more prominent in Hispanic individuals.</div></div><div><h3>Conclusions</h3><div>MetS prevalence has increased over 2 decades. Persistent racial/ethnic disparities exist in antihypertensive, antihyperglycemic, and lipid-lowering medication use. Across all racial/ethnic subgroups, large opportunities remain for improving treatment strategies among individuals with medication indications.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 6","pages":"Article 101785"},"PeriodicalIF":0.0000,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Trends in Prevalence, Treatment, and Relationship of Metabolic Syndrome and Individual Components by Race/Ethnicity, 1999-2018\",\"authors\":\"Yuan Lu ScD , Xumin Li MS , Yuntian Liu MPH , César Caraballo MD , Daisy Massey BA , Shiwani Mahajan MD, MHS , Erica Spatz MD, MHS , Jeph Herrin PhD , Harlan M. Krumholz MD, SM\",\"doi\":\"10.1016/j.jacadv.2025.101785\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Nationally representative data on recent trends in racial/ethnic differences in metabolic syndrome (MetS) prevalence and treatment are sparse.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to examine 20-year trends in the prevalence, treatment, and interrelationships of MetS and its individual components among U.S. adults, overall and by race/ethnicity.</div></div><div><h3>Methods</h3><div>We evaluated trends from 1999 to 2018 in 20,397 adults using data from the National Health and Nutrition Examination Survey. Age-standardized prevalence estimates were calculated for MetS, its components, and related prescription drug use. Trends were assessed using weighted linear regression, and racial/ethnic disparities were examined using <em>t</em>-tests.</div></div><div><h3>Results</h3><div>The mean age was 47.5 (47.4-47.6) years; 51.3% were female; 77.9%, 12.8%, and 9.4% were White, Black, and Hispanic, respectively. MetS prevalence increased significantly from 1999 to 2018 across all groups (<em>P</em> < 0.001). Among MetS components, waist circumference and fasting glucose increased across all groups, while triglycerides increased only among Black individuals. Lipid-lowering medication use increased (<em>P</em> < 0.001), but racial/ethnic disparities persisted. Compared to White individuals, Hispanic individuals had lower antihypertensive and lipid-lowering medication use (<em>P</em> < 0.01). Despite increased prescriptions, <65% of eligible individuals received lipid-lowering therapy, and <35% received antihyperglycemic therapy, highlighting substantial treatment gaps. Racial/ethnic differences in MetS component relationships were observed: blood pressure played a larger role in Black individuals, while fasting glucose was more prominent in Hispanic individuals.</div></div><div><h3>Conclusions</h3><div>MetS prevalence has increased over 2 decades. Persistent racial/ethnic disparities exist in antihypertensive, antihyperglycemic, and lipid-lowering medication use. Across all racial/ethnic subgroups, large opportunities remain for improving treatment strategies among individuals with medication indications.</div></div>\",\"PeriodicalId\":73527,\"journal\":{\"name\":\"JACC advances\",\"volume\":\"4 6\",\"pages\":\"Article 101785\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-05-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JACC advances\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2772963X25002030\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JACC advances","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2772963X25002030","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Trends in Prevalence, Treatment, and Relationship of Metabolic Syndrome and Individual Components by Race/Ethnicity, 1999-2018
Background
Nationally representative data on recent trends in racial/ethnic differences in metabolic syndrome (MetS) prevalence and treatment are sparse.
Objectives
The purpose of this study was to examine 20-year trends in the prevalence, treatment, and interrelationships of MetS and its individual components among U.S. adults, overall and by race/ethnicity.
Methods
We evaluated trends from 1999 to 2018 in 20,397 adults using data from the National Health and Nutrition Examination Survey. Age-standardized prevalence estimates were calculated for MetS, its components, and related prescription drug use. Trends were assessed using weighted linear regression, and racial/ethnic disparities were examined using t-tests.
Results
The mean age was 47.5 (47.4-47.6) years; 51.3% were female; 77.9%, 12.8%, and 9.4% were White, Black, and Hispanic, respectively. MetS prevalence increased significantly from 1999 to 2018 across all groups (P < 0.001). Among MetS components, waist circumference and fasting glucose increased across all groups, while triglycerides increased only among Black individuals. Lipid-lowering medication use increased (P < 0.001), but racial/ethnic disparities persisted. Compared to White individuals, Hispanic individuals had lower antihypertensive and lipid-lowering medication use (P < 0.01). Despite increased prescriptions, <65% of eligible individuals received lipid-lowering therapy, and <35% received antihyperglycemic therapy, highlighting substantial treatment gaps. Racial/ethnic differences in MetS component relationships were observed: blood pressure played a larger role in Black individuals, while fasting glucose was more prominent in Hispanic individuals.
Conclusions
MetS prevalence has increased over 2 decades. Persistent racial/ethnic disparities exist in antihypertensive, antihyperglycemic, and lipid-lowering medication use. Across all racial/ethnic subgroups, large opportunities remain for improving treatment strategies among individuals with medication indications.
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