Effects of smoking, alcohol, exercise, education, and family history on the metabolic syndrome as defined by the ATP III

Introduction: Although several environmental factors are known to have diverse effects on the development of the metabolic syndrome, few studies have examined their relevance to Asians. Methods: We gathered data from 4341 subjects on smoking, alcohol drinking, exercise, family history and education level by a self-administered questionnaire. The components of the metabolic syndrome as defined by the ATP III report were examined. Results: The multivariate-adjusted odds ratio of hypertriglyceridemia was 1.4 (95% CI 1.0-1.8) and of low HDL-C was 1.9 (95% CI 1.3-2.6) in subjects who smoked more than 20 pack-years compared to nonsmokers. The relative risk of developing the metabolic syndrome in smokers (more than 20 pack-years) was 1.9 (95% CI 1.1-3.7) compared to nonsmokers. Alcohol consumption had a protective effect against low HDL-C (adjusted OR 0.6-0.2). The relative risk of the metabolic syndrome was 1.7 (95% CI 0.9-2.8) for lack of exercise, 1.5 (95% CI 1.1-2.1) for a positive family history and 2.0 (95% CI 1.2-3.4) in those with no or an elementary school education versus university graduation. Conclusion: Since subjects with a low education level and a family history had an elevated risk for the metabolic syndrome and thus for developing cardiovascular disease, particular attention should be paid to these subjects.