# Prevalence of metabolic syndrome and its association with cardiovascular disease risk and common risk factors amongst healthcare workers in Pakistan

## TL;DR

This study found that 37% of healthcare workers in Pakistan have metabolic syndrome, which is strongly linked to higher cardiovascular disease risk and depression.

## Contribution

The study provides new insights into the prevalence and risk factors of metabolic syndrome among healthcare workers in Pakistan.

## Key findings

- Low HDL and elevated waist circumference were the most common components of metabolic syndrome.
- Metabolic syndrome was 5.7 times more likely in individuals with high cardiovascular disease risk.
- Depression was significantly associated with metabolic syndrome, but tobacco use was not.

## Abstract

Metabolic syndrome (MetS) significantly increases the risk of cardiovascular disease (CVD). Healthcare workers (HCWs) are at a higher risk of CVD. However, little is known about the association between MetS and CVD risk in healthcare workers in Pakistan. We aimed to assess the prevalence of MetS and its components and examined the association between MetS and 10-year CVD-risk using Framingham Risk Score (FRS) and common CVD risk factors amongst HCWs working in a private healthcare system in Pakistan. This cross-sectional study uses baseline data from an existing CVD risk screening program for employees at a private healthcare system in Pakistan. MetS was diagnosed using the American Heart Association cut-offs for Asian population. Healthcare workers were divided into MetS positive and negative groups; demographics, MetS components and CVD risk were compared between these groups. Logistic regression was used to examine the association of MetS with 10-year CVD-risk and its risk factors. In 1,807 healthcare workers, 677 (37%) had MetS and 48 (2.7%) had a high 10-year CVD-risk. Of the MetS components, low High-density Lipoprotein (HDL) 1,467 (81%) and elevated waist circumference (WC) 1,049 (58%) were the most prevalent. Compared to MetS negative group, MetS positive group had a higher proportion of high-risk CVD (0.7% vs. 5.9%; p: <0.01). After controlling for known risk factors, we found that the odds of having MetS is 5.7 times higher (aOR: 5.67 (95% CI: 2.39–13.4) in those with high CVD risk. In addition, we found a significant association between screening positive for depression and MetS (OR: 2.42 (95% CI: 1.24–4.72). Interestingly, tobacco use was not significantly associated with MetS (OR: 0.81 (95% CI: 0.58–1.15). We found a high prevalence of MetS amongst Pakistani healthcare workers and of the MetS components, low HDL and elevated WC were the most prevalent. Along with biologic risk factors (age, sex and family history of CVD), depression significantly increases the odds of having MetS. In addition, both intermediate and high CVD risk groups have significant association with MetS. Comprehensive, workplace based screening and management programs are required for HCWs to mitigate the risk of MetS and cardiovascular disease. Early identification and treatment of these risk factors may be cost-effective in lowering MetS burden in low-middle income countries.