Between 2011 and 2016, a significant increase in the prevalence of metabolic syndrome was identified among American adults aged 20 to 39 years, according to a study published in JAMA.1 Specifically, the greatest increase in prevalence was found among women and people of Hispanic or Asian descent.  

Metabolic syndrome is linked to cardiovascular disease, stroke, type 2 diabetes, and all-cause mortality;2 understanding these associations can help reveal opportunities for optimizing screening and developing a better profile of at-risk patients, reported the authors of the study.

Data from the National Health and Nutrition Examination Survey was used to analyze the prevalence of metabolic disorders in American adults aged ≥20 years. Patients were grouped according to their self-reported race and ethnicity, sex, and age group (aged 20-39, 40-59, and ≥ 60 years).

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Among the 27,048 participants, the overall prevalence of metabolic syndrome was 34.7%, rising from 32.5% in the 2011 to 2015 period to 36.9% in the 2015-2016 period. Although the overall rise in metabolic syndrome did not reach statistical significance, there was a significant change among certain subsets of the study population. Among adults aged 20 to 39 years, the prevalence of metabolic syndrome increased by 5.2% over the study period (16.2% to 21.3%). An increase in prevalence was also seen in women (4.9%: rising from 31.7% to 36.6%), participants of Asian descent (6.3%: rising from 19.9% to 26.2%), and Hispanic descent (7.5%: rising from 32.9% to 40.5%).  

Metabolic syndrome also increased with age. In adults aged ≥60 years, the prevalence of metabolic syndrome increased to 48.6%. However, the prevalence was not evenly distributed among ethnicities. The group with the highest overall prevalence was among participants who indicated “other” race/ethnicity and were at least 60 years old. (64.0%), followed by Hispanic participants who were at least 60 years old (57.3%).

This study was inherently limited by flaws in NHANES dataset, for example, nonresponse bias, potential misclassification of medication use, as well as use of the term “other” to categorize race, said Robert J. Wong, MD, MS, coauthor of the study, in an email interview. Limitations of this data also include the lack of race-specific abdominal obesity guidelines, which may have influenced the accuracy of results, especially for participants of Asian descent, he added. In addition, information about the severity or control of each component of metabolic syndrome was not available.

“The fast-growing prevalence [of metabolic syndrome] in young adults and Hispanic and Asian individuals is important to note given their increasing population in the United States,” the researchers stated. “Efforts to implement prevention strategies [for the development of metabolic syndrome], including lifestyle modification, and use of medications targeted at subgroups at highest risk, may assist in lowering the risk of developing cardiovascular disease.”

Disclosure: Dr Wong reported receiving research grants from Gilead Sciences and Abbvie and being part of the advisory board and speaker’s bureau for Gilead Science.


  1. Hirode G, Wong RJ. Trends in the prevalence of metabolic syndrome in the United States, 2011-2016. JAMA. 2020:323(24)2526-2528.
  2. Isomaa B, Almgren P, Tuomi T, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001;24(4):683-689.