Research Article: Clustering of four major lifestyle risk factors among Korean adults with metabolic syndrome

Date Published: March 28, 2017

Publisher: Public Library of Science

Author(s): Shin Ha, Hui Ran Choi, Yo Han Lee, Tatsuo Shimosawa.


The purpose of this study was to investigate the clustering pattern of four major lifestyle risk factors—smoking, heavy drinking, poor diet, and physical inactivity—among people with metabolic syndrome in South Korea. There were 2,469 adults with metabolic syndrome aged 30 years or older available with the 5th Korean National Health and Nutrition Examination Survey dataset. We calculated the ratio of the observed to expected (O/E) prevalence for the 16 different combinations and the prevalence odds ratios (POR) of four lifestyle risk factors. The four lifestyle risk factors tended to cluster in specific multiple combinations. Smoking and heavy drinking was clustered (POR: 1.86 for male, 4.46 for female), heavy drinking and poor diet were clustered (POR: 1.38 for male, 1.74 for female), and smoking and physical inactivity were also clustered (POR: 1.48 for male). Those who were male, younger, low-educated and living alone were much more likely to have a higher number of lifestyle risk factors. Some helpful implications can be drawn from the knowledge on clustering pattern of lifestyle risk factors for more effective intervention program targeting metabolic syndrome.

Partial Text

Metabolic syndrome is a clustering of cardio-metabolic risk factors. People with metabolic syndrome are much more likely to have cardiovascular disease (CVD) and type 2 diabetes, respectively than people without metabolic syndrome [1–3]. The prevalence of metabolic syndrome has steadily increased and is now a serious public health concern in developed countries [4,5].

Table 1 shows the characteristics of the study population. Compared with male subjects, females tended to be older, in the lower income, less educated, living alone, and not employed. Males were highly likely to be smokers, heavy drinkers, and to have poor diet than female subjects, whereas the prevalence of physical inactivity was similar in both sexes. Of the males, 11% had no lifestyle risk factor, 26% had one, 37% had two, and 26% had simultaneously three or more lifestyle risk factors. Meanwhile, more than 80% of female participants had nothing or only one lifestyle risk factor.

In the present study we investigated the clustering of these four major lifestyle risk factors such as smoking, heavy drinking, poor diet, and physical inactivity among a representative sample of adult Korean population with metabolic syndrome. Most previous studies on clustering of risk factors have examined the clustering of metabolic risk factors [18–25] and not lifestyle risk factors.




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