BackgroundIndividuals with metabolic syndrome (MetS) are at increased riskof morbidity and mortality from a variety of health conditions,thus making MetS an important trait to recognize and treat. Thedefinition of MetS changed over the past decade as researchersidentified the most critical risk factors. The first widely useddefinitions were developed by the World Health Organization [1]and the National Institutes of Health [2]. Currently, the bestregarded definition of MetS is that of the American Heart Associationand National Heart, Lung and Blood Institute [3], whichhas a high utility in determining those at risk. Their definitionconfirmed the value of the Adult Treatment Panel III criteria [2]with some minor modifications, making the current standard forMetS risk criteria based on the following: waist circumference(102 cm in men, 88 cm in women, or body mass index[BMI] > 30 kg/m2), triglycerides 150 mg/dl, high-density lipoprotein[HDL] cholesterol (<40 mg/dl for men or <50 mg/dl forwomen, or taking cholesterol medication), blood pressure(130/85 mmHg or blood pressure medication), and fastingglucose (100 mg/dl or glucose medication).Because MetS is characterized by many of the accepted riskfactors of cardiovascular disease (CVD), the former is thought tobe a strong predictor of the latter. In fact, many researchers havefound that the risks of developing CVD (and subsequent death)are higher among those with MetS compared to those withoutthe syndrome [4–13]. But, because of the obvious overlapbetween MetS and CVD risk factors, some argue that MetS doesnot provide any additional information about cardiovascular riskfactors [14]. Others contend that the combined effect of theserisk factors is greater than the sum of its parts, and that knowledgeof MetS is helpful and informative in predicting CVD [14].Individuals with MetS are also at a higher risk of developingdiabetes (five times higher in one study [14]) compared to thosewithout MetS [15–17]. Again, this is not unexpected because ofthe MetS risk factor of elevated fasting glucose levels, a characteristicof diabetes. Other medical conditions found to be associatedwith MetS include the chronic pain condition fibromyalgia[18], carpal tunnel syndrome [19–21], asthma [22], and polycysticovary syndrome [23,24].None of these previously mentioned studies, however, wereconducted in a worksite population. Corporations are the mainpayers of health-care costs in the United States; thus, they have amore vested interest than corporations in other countries inidentifying the magnitude of MetS risk factors in employed populationsand in knowing if these risks are associated with otherhealth risks or medical conditions. Many companies offer wellnessprograms to encourage their employees to maintain ahealthy lifestyle, thereby reducing health risks such as those thatdefine MetS.
This study identified the prevalence of MetS risk factors in
employees of a large manufacturing corporation who participated
in a health risk appraisal (HRA) screening in 2004 and
again in 2006. The presence of disease was assessed through
self-report at time 1 in 2004 and at time 2 in 2006 to see if MetS
risk factors were associated with increased rates of disease in an
employed population. Furthermore, health-care costs, pharmacy
costs, and short-term disability (STD) costs were measured
among those who met the criteria for MetS, but did not yet have
an associated disease to see if the risk factors alone are associated
with higher costs.
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