Diagnostic Criteria for Metabolic Syndrome in High-Altitude Regions: A Systematic Review

Abstract

Background and Objectives: Metabolic syndrome (MS) has many risk factors that are important to investigate in populations living at sea level and in high-altitude geographic regions. The aim was to identify the components of MS that cross-sectional studies use to assess in adult populations residing in high-altitude regions. Materials and Methods: A systematic review study was conducted. The Pubmed database was used. The search for original articles (cross-sectional) was performed from January 2013 to December 2020. The procedure was carried out by two researchers. The keywords used were metabolic syndrome, adults, and altitude regions. The search strategy considered the components of the PICOS tool. Results: Ten cross-sectional studies were identified in the Pubmed database from 2014 to 2020. Altitude levels varied between countries and regions, from 2060 to 4900 m above sea level. Three studies were conducted in both China and Peru, two studies in Ecuador, and one in Bolivia and India. The age ranges studied were from 18 to ~80 years of age, approximately. The components used to assess MS in most studies (between 9 to 10 studies) were body mass index (BMI), waist circumference (WC), blood pressure (BP), triglycerides (TG), high-density lipoproteins (HDL) and serum glucose (SG). Conclusions: This systematic review verified that the most commonly used domains in adult populations in various moderate- and high-altitude regions of the world are BMI, WC, BP, TG, HDL, and SG. These results suggest that in order to evaluate and/or investigate MS in subjects residing in high-altitude populations, at least four diagnostic domains should be considered in their protocols.

Altitude and metabolic syndrome in China: Beneficial effects of healthy diet and physical activity

“…There is limited evidence on the correlation between altitude and metabolic syndrome, as most studies focused on metabolic profiles among people living at high altitudes [25] without comparing metabolic syndrome at different altitudes. Only one cross-sectional study involving 260 Ecuadorians has shown an inverse correlation between metabolic syndrome and altitude [26].…”

Concordancia entre cinco criterios de síndrome metabólico en adolescentes de una zona altoandina del Perú

“…This study applied the International Diabetes Federation (IDF) criteria. ATP-III and IDF use blood pressure, some indicator of obesity, HDL cholesterol, triglycerides and serum glucose as components, which are the most frequently used components in cross-sectional studies to measure MetS in the population living at high altitudes 6 .…”

“…Este estudio aplicó los criterios de la International Diabetes Federation (IDF). ATP-III e IDF usan como componentes a la presión arterial, algún indicador de obesidad, colesterol HDL, triglicéridos y glucosa sérica; los cuales son los componentes más frecuentemente usados por estudios transversales para medir SM en población residente en elevadas altitudes 6 .…”