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Canadian Journal of Cardiology

ROLE OF SEX AND GENDER IN DEVELOPMENT OF METABOLIC SYNDROME: A PROSPECTIVE COHORT STUDY

      Background

      The burden of metabolic syndrome (MetS) and its components has been increasing mainly amongst male individuals. Nevertheless, clinical outcomes related to MetS (i.e., cardiovascular diseases), are worse among females. Whether these sex differences in the components and sequalae of MetS are influenced by psycho-socio-cultural factors (gender) is a matter of debate. Therefore, the purpose of this study was to determine the association between gender-related factors and the development of MetS, and to assess if the magnitude of the associations vary by sex.

      Methods and Results

      Data from the Colaus/PsyColaus study, a prospective population-based cohort of 6,734 middle-aged participants in Lausanne (Switzerland) (2003-2006) were used. The primary endpoint was the development of MetS as defined by the Adult Treatment Panel III of the National Cholesterol Education Program. Multivariable models were estimated using logistic regression to assess the association between gender-related factors and the development of MetS. Two-way interactions between sex and age and gender-related factors were also tested. Among 5,195 participants without MetS (mean age=51.3±10.6, 56.1% females), 27.9% developed MetS during a mean follow-up of 10.9 years. Female sex (OR:0.48, 95%CI:0.41- 0.55) was associated with decreased risk of developing MetS. Conversely, older age, educational attainment less than university, and low income were associated with an increased risk of developing MetS. Statistically significant interaction between sex and strata of age, education, income, smoking, and employment were identified. The reduced risk of MetS in females was attenuated in the lowest education, income, and advanced age strata. However, females who smoke and reported being employed demonstrated increased risk of METS. Conversely smoking and unemployment were significant risk factors for MetS development among male adults.