Prevalence Of Metabolic Syndrome and Its Associated Factors Among Thai Police Officers – A Population-Based Study

Mahesh Gurung; Runyawan Chotenimitkhun; Kasem Ratanasumawong; Bundit Prommete Prommete; Wichai Aekplakorn

doi:10.33192/smj.v75i3.260869

Authors

Mahesh Gurung Cardiology Division, Police General Hospital, Thailand, and Jigme Dorji Wangchuck National Referral Hospital, Thimphu
Runyawan Chotenimitkhun Cardiology Division, Police General Hospital, Bangkok
Kasem Ratanasumawong Cardiology Division, Police General Hospital, Bangkok
Bundit Prommete Prommete Cardiology Division, Police General Hospital, Bangkok
Wichai Aekplakorn Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok

DOI:

https://doi.org/10.33192/smj.v75i3.260869

Keywords:

Metabolic syndrome, prevalence, police officers, Thai

Abstract

Objective: The prevalence of Metabolic Syndrome (MetS) in Thai police officers is unknown. This study aims to accurately determine the prevalence of MetS in this population compared to the Thai general population.

Materials and Methods: We conducted a population-based cross-sectional study of 107,933 Thai police officers during the 2012 annual Police Health Care Center check-up. Metabolic syndrome was defined using the harmonized criteria of six international expert groups.

Results: The prevalence of MetS among Thai police officers was 39.24%, with a higher prevalence among males compared to female police officers (40.9% male and 14.3% female). The prevalence was higher in male police officers (40.65% versus 23.80%, P<0.001), whereas it was lower in female officers (16.30% versus 31.59%, P<0.001) when compared to the general population. High blood pressure was the most common abnormal metabolic component in both genders (male 67.4 % female 33.3%). Whereas observation of low high-density lipoprotein cholesterol (HDL) in males (11.6%) and high fasting plasma glucose (FG) in females (16.3%). The adjusted odds ratio for MetS increased with age, wide pulse pressure, male gender, lower rank, alcohol drinking, and being in a non-metropolitan city.

Conclusion: The prevalence of MetS is higher among Thai police officers compared to the general Thai population. These findings underscore the need for effective preventive measures and continuous monitoring to reduce the risk and burden of cardiovascular diseases.

References

Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, et al. The metabolic syndrome and cardiovascular risk: A systematic review and meta-analysis. J Am Coll Cardiol 2010;56:1113-32. https://doi.org/10.1016/j.jacc.2010.05.034.

Grundy SM. Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol 2008;28:629-36. https://doi.org/10.1161/ATVBAHA.107.151092.

Moore JX, Chaudhary N, Akinyemiju T. Metabolic syndrome prevalence by race/ ethnicity and sex in the united states, national health and nutrition examination survey, 1988-2012. Prev Chronic Dis 2017;14:E24. https://doi.org/10.5888/pcd14.160287.

Ranasinghe P, Mathangasinghe Y, Jayawardena R, Hills AP, Misra A. Prevalence and trends of metabolic syndrome among adults in the asia-pacific region: a systematic review. BMC Public Health 2017;17:101. https://doi.org/10.1186/s12889-017-4041-1.

Scuteri A, Laurent S, Cucca F, Cockcroft J, Cunha PG, Mañas LR, et al. Metabolic syndrome across Europe: Different clusters of risk factors. Eur J Prev Cardiol 2015;22:486-91. https://doi.org/10.1177/2047487314525529.

Aekplakorn W, Kessomboon P, Sangthong R, Chariyalertsak S, Putwatana P, Inthawong R, et al. Urban and rural variation in clustering of metabolic syndrome components in the Thai population: Results from the fourth National Health Examination Survey 2009. BMC Public Health 2011;11:854. https://doi.org/10.1186/1471-2458-11-854.

Aekplakorn W, Chongsuvivatwong V, Tatsanavivat P, Suriyawongpaisal P. Prevalence of metabolic syndrome defined by the International Diabetes Federation and National Cholesterol Education Program criteria among Thai adults. Asia-Pacific J Public Heal 2011;23:792-800. https://doi.org/10.1177/1010539511424482.

Suriyawongpaisal P. Cardiovascular risk factor levels in urban and rural Thailand - The International Collaborative Study of Cardiovascular Disease in Asia (InterASIA). Eur J Cardiovasc Prev Rehabil 2003;10:249-57. https://doi.org/10.1097/00149831-200308000-00006.

Garbarino S, Magnavita N. Sleep problems are a strong predictor of stress-related metabolic changes in police officers. A prospective study. PLoS One 2019;14(10):e0224259. https://doi.org/10.1371/journal.pone.0224259.

Violanti JM, Burchfiel CM, Hartley TA, Mnatsakanova A, Fekedulegn D, Andrew ME, et al. Atypical work hours and metabolic syndrome among police officers. Arch Environ Occup Heal 2009;64:194-201. https://doi.org/10.1080/19338240903241259.

da-Silva CAC, Leite AL, Moreira JA, Abreu DDC, Oliveira PE de A, Nunes DP, et al. Association of dyslipidemia, hypertension and overweight/obesity with work shift and duration of employment among police officers in a small town in Northeastern Brazil. Rev Bras Med Do Trab Publicacao Of Da Assoc Nac Med Do Trab 2019;17:537-44. https://doi.org/10.5327/Z1679443520190401.

Hartley TA, Fekedulegn D, Knox SS, Burchfiel CM, Andrew ME, Violanti JM. Associations between police officer stress and the metabolic syndrome. Int J Emerg Ment Health 2011;13:243-56.

Chang JH, Huang PT, Lin YK, Lin CE, Lin CM, Shieh YH, et al. Association between sleep duration and sleep quality, and metabolic syndrome in Taiwanese police officers. Int J Occup Med Environ Health 2015;28:1011-23. https://doi.org/10.13075/ijomeh.1896.00359.

Violanti JM, Hartley TA, Charles LE, Fekedulegn D, Andrew ME, Mnatsakanova A, et al. Police trauma and cardiovascular disease: Association between PTSD symptoms and metabolic syndrome. Int J Emerg Ment Health 2006;8:227-38.

Rostami H, Tavakoli HR, Rahimi MH, Mohammadi M. Metabolic Syndrome Prevalence among Armed Forces Personnel (Military Personnel and Police Officers): A Systematic Review and Meta-Analysis. Mil Med 2019;184:e417-25. https://doi.org/10.1093/milmed/usz144.

Chandramohan P, Mohan V. High prevalence of diabetes and metabolic syndrome among policemen. J Assoc Physicians India 2008;56:837-8.

Tharkar S, Kumpatla S, Muthukumaran P, Viswanathan V. High prevalence of metabolic syndrome and cardiovascular risk among police personnel compared to general population in India. J Assoc Physicians India 2008;56:845-9.

Hong JH, Lee S-W. A Study on the Prevalence and Influencing Factors of Metabolic Syndrome among Police Officers. J Korean Soc Occup Environ Hyg 2014;24:566-77. https://doi.org/10.15269/jksoeh.2014.24.4.566.

Zhang J, Liu Q, Long S, Guo C, Tan H. Prevalence of metabolic syndrome and its risk factors among 10,348 police officers in a large city of China: A cross-sectional study. Med (United States) 2019;98(40):e17306. https://doi.org/10.1097/MD.0000000000017306.

Nillakupt K, Viravathana N. A survey of metabolic syndrome and its components in Thai medical cadets. J Med Assoc Thai 2010;93 Suppl 6:S179-85.

Napradit P, Pantaewan P, Nimit-arnun N, Souvannakitti D, Rangsin R. Prevalence of overweight and obesity in Royal Thai Army personnel. J Med Assoc Thail 2007;90:335-40.

National Statistical office, National Statistical Office Thailand, Technology M of I and communication. Key Statistics of Thailand 2012. 2012.

World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Heal Organ - Tech Rep Ser 2000;894:253.

Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG, et al. Clinical Practice Guidelines for the Management of Hypertension in the Community: A Statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich) 2014;16(1):14-26. https://doi.org/10.1111/jch.12237.

Knopfholz J, Disserol CCD, Pierin AJ, Schirr FL, Streisky L, Takito LL, et al. Validation of the friedewald formula in patients with metabolic syndrome. Cholesterol 2014;2014:261878. https://doi.org/10.1155/2014/261878.

Certified AS, Cholesterol LDL. Cholesterol Reference Method Laboratory Network List of Analytical Systems Certified for LDL Cholesterol 2010;186:1-9.

Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: A joint interim statement of the international diabetes federation task force on epidemiology and prevention; National heart, lung, and blood institute; American heart association; World heart federation; International atherosclerosis society; And international association for the study of obesity. Circulation 2009;120:1640-5. https://doi.org/10.1161/CIRCULATIONAHA.109.192644.

Shiwaku K, Nogi A, Kitajima K, Anuurad E, Enkhmaa B, Yamasaki M, et al. Prevalence of the metabolic syndrome using the modified ATP III definitions for workers in Japan, Korea and Mongolia. J Occup Health 2005;47:126-35. https://doi.org/10.1539/joh.47.126.

Lohsoonthorn V, Lertmaharit S, Williams MA. Prevalence of metabolic syndrome among professional and office workers in Bangkok, Thailand. J Med Assoc Thai 2007;90:1908-15.

National Statistical Office Thailand, Ministry of Information and communication technology. The Population And Housing Census 2010. http://service.nso.go.th/nso/nso_center/project/search_center/23project-en.htm.

Filho RTB, D’Oliveira A. The Prevalence of Metabolic Syndrome Among Soldiers of the Military Police of Bahia State, Brazil. Am J Mens Health 2014;8:310–5. https://doi.org/10.1177/1557988313510928.

Yoo H. Assessment of contributors to the metabolic syndrome among law enforcement officers. ProQuest Diss Theses 2011:116.

Shiozaki M, Miyai N, Morioka I, Utsumi M, Koike H, Arita M, et al. Assessment of the risk of ischemic heart disease and its relevant factors among Japanese police officers. Sangyo Eiseigaku Zasshi 2013;55(4):115-24. https://doi.org/10.1539/sangyoeisei.B12007.

Thayyil J, Jayakrishnan TT, Raja M, Cherumanalil JM. Metabolic syndrome and other cardiovascular risk factors among police officers. N Am J Med Sci 2012;4:630-5. https://doi.org/10.4103/1947-2714.104313.

Tharkar S, Kumpatla S, Muthukumaran P, Viswanathan V. High prevalence of metabolic syndrome and cardiovascular risk among police personnel compared to general population in India. J Assoc Physicians India 2008;56:845-9.

Febyan ., Wetarini K, Rendy ., Thintarso CS, Suastika K. A Clinical Profile of Metabolic Syndrome and Its Determinants among Police Officers in Bali. Eur J Med Heal Sci 2020;2. https://doi.org/10.24018/ejmed.2020.2.6.619.

Strauss M, Foshag P, Brzek A, Vollenberg R, Jehn U, Leischik R. Metabolic syndrome in female police officers and female office workers: A cross-sectional study in occupations with different physical activities. Diabetes, Metab Syndr Obes Targets Ther 2020;13:3487-95. https://doi.org/10.2147/DMSO.S267948.

Wang WY, Li CH, Wu YS, Chien WC, Wang KY, Tzeng WC. Gender Differences in the Prevalence of Metabolic Syndrome Among Taiwanese Air Force Personnel: A Population-Based Study. J Cardiovasc Nurs 2020;35:502-11. https://doi.org/10.1097/JCN.0000000000000714.

Vona R, Gambardella L, Straface E. Gender-Associated Biomarkers in Metabolic Syndrome. Carotid Artery - Gend. Heal. [Working Title], IntechOpen; 2018. https://doi.org/10.5772/intechopen.81103.

Ventura-Clapier R, Dworatzek E, Seeland U, Kararigas G, Arnal J-F, Brunelleschi S, et al. Sex in basic research: concepts in the cardiovascular field. Cardiovasc Res 2017;113:711-24. https://doi.org/10.1093/cvr/cvx066.

Gerdts E, Regitz-Zagrosek V. Sex differences in cardiometabolic disorders. Nat Med 2019;25:1657-66. https://doi.org/10.1038/s41591-019-0643-8.

Shungin D, Winkler TW, Croteau-Chonka DC, Ferreira T, Locke AE, Mägi R, et al. New genetic loci link adipose and insulin biology to body fat distribution. Nature 2015;518:187-96. https://doi.org/10.1038/nature14132.

Yates JD, Aldous JWF, Bailey DP, Chater AM, Mitchell ACS, Richards JC. The prevalence and predictors of hypertension and the metabolic syndrome in police personnel. Int J Environ Res Public Health 2021;18(13):6728. https://doi.org/10.3390/ijerph18136728.

Janczura M, Rosa R, Dropinski J, Gielicz A, Stanisz A, Kotula-Horowitz K, et al. The associations of perceived and oxidative stress with hypertension in a cohort of police officers. Clin Cosmet Investig Dermatol 2021;14:1783-97. https://doi.org/10.2147/DMSO.S298596.

Pradhan AD. Sex Differences in the Metabolic Syndrome: Implications for Cardiovascular Health in Women 2013. https://doi.org/10.1373/clinchem.2013.202549.

Lovejoy JC, Champagne CM, De Jonge L, Xie H, Smith SR. Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes 2008;32:949-58. https://doi.org/10.1038/ijo.2008.25.

Trivedi T, Liu J, Probst JC, Martin AB. The Metabolic Syndrome: Are Rural Residents at Increased Risk? J Rural Heal 2013;29:188-97. https://doi.org/10.1111/J.1748-0361.2012.00422.X.

Atanasova G, Yordanova - Laleva P, Marinov MA. Metabolomics and biomarkers. Clin Chem Lab Med 2017;55:22-5. https://doi.org/10.1515/cclm-2017-7062.

Kwon YJ, Chung TH, Shim JY, Lee YJ. The association of pulse pressure with metabolic syndrome in Korean elderly: A nationwide population-based study. Diabetes Res Clin Pract 2017;123:75-81. https://doi.org/10.1016/J.DIABRES.2016.11.027.

Xin S, Feng-shi T, Song Y, Xin S, Feng-shi T, Song Y. Prevalence and influencing factors of metabolic syndrome among police. Chinese Journal of Public Health 2010;26:1376-8. https://doi.org/10.11847/zgggws2010-26-11-16.

Santos Fontes IS, Sampaio CG, Dos Santos CG, Sá Barros AMM, Fontes DS, Dos Santos IMC, et al. Síndrome metabólica em militares de uma unidade da polícia de Aracaju, Sergipe. Sci Med (Porto Alegre) 2016;26:24160. https://doi.org/10.15448/1980-6108.2016.3.24160.

Li Y-Q, Zhao L-Q, Liu X-Y, Wang H-L, Wang X-H, Li B, et al. Prevalence and distribution of metabolic syndrome in a southern Chinese population. Relation to exercise, smoking, and educational level. Saudi Med J 2013;34:929–36.

(US) NC for HS. Health, United States, 2011. Heal United States, 2011 With Spec Featur Socioecon Status Heal 2012.

Cathal Doyle, Paul Kavanagh, Owen Metcalfe TL. Health Impacts of Employment a review Prepared by. 2005.

Mullington JM, Haack M, Toth M, Serrador JM, Meier-Ewert HK. Cardiovascular, Inflammatory, and Metabolic Consequences of Sleep Deprivation. Prog Cardiovasc Dis 2009;51:294-302. https://doi.org/10.1016/j.pcad.2008.10.003.

van Leeuwen WMA, Lehto M, Karisola P, Lindholm H, Luukkonen R, Sallinen M, et al. Sleep restriction increases the risk of developing cardiovascular diseases by augmenting proinflammatory responses through IL-17 and CRP. PLoS One 2009;4(2):e4589. https://doi.org/10.1371/journal.pone.0004589.