Metabolic Syndrome in the Military Health System Based on Electronic Health Data, 2009–2012

Abstract

Metabolic syndrome prevalence in the United States rose from 27% to 34.2% between 1999-2000 and 1999-2006. However, prevalence has not been determined in the Military Health System. This retrospective descriptive study included enrolled Military Health System adults during fiscal years 2009-2012. We explored three populations (nonactive duty, active duty, and Air Force active duty) and their metabolic syndrome components (body mass index or waist circumference, blood glucose test, triglyceride, high density lipoprotein, and blood pressure). The active duty sample (who had all five components measured) was representative of its population, but the nonactive duty sample was not. Therefore, we reported component-wise prevalence for both nonactive and active duty populations, but only reported prevalence of metabolic syndrome for active duty. A decreasing trend, greater in men, was seen. Crude prevalence in 2012 was higher among men and highest among males and females aged 45-64. Only Air Force active duty data contained waist circumference measurements, enabling comparison to the United States. This subgroup prevalence was significantly lower than the United States prevalence in 2010 for both genders in every age group. Although decreasing metabolic syndrome prevalence is promising, prevalence is still high and future research should explore policies to help lower the prevalence.

The Prevalence of Obesity and Metabolic Syndrome in the Korean Military Compared with the General Population

“…The prevalence of MS in military personnel was significantly lower than that of the general population. 21 Soldiers tend to have higher BP and smoke more but have better lipid profile, fasting glucose and lower BMI than the general public. 17 However, the prevalence of MS in military personnel in the current study was significantly lower than other studies.…”

Global prevalence of cardiometabolic risk factors in the military population: a systematic review and meta-analysis

“…According to random effect meta-analysis, the rates of the global pooled prevalence (95% confidence interval) of MetS, high LDL, high TC, high TG, low HDL and high FBS were 21% (17-25), 32% (27)(28)(29)(30)(31)(32)(33)(34)(35)(36), 34% (10-57), 24% (16-31), 28% and 9% (5-12), respectively. Moreover, the rates of the global estimated pooled prevalence of overweight, generalized obesity, abdominal obesity and HTN were 35% (31-39), 14% (13)(14)(15)(16), 29% (20-39) and 26% (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), respectively. Figure 2 shows a forest plot of eligible articles for the estimation of MetS prevalence.…”

HDL-C As Most Predictive Variable of Visceral Adipose Tissue in Young Military Personnel of the National Guard

“…For both genders in the active duty population, the component threshold prevalence was described to increase with increasing age for all components except HDL-C while the trend for the nonactive duty population was less clear, making a reference to our study observations difficult. Herzog et al (2015) report active duty MetS prevalence was higher among men and highest in the 45-64 age group for both genders in the active duty sample. An important comment by the researchers described the strength in the study recognizing the "impact of the healthy worker effect in active duty on MetS prevalence" which followed with their separation of active and nonactive duty populations for analyses (Herzog et al, 2015).…”

“…An important comment by the researchers described the strength in the study recognizing the "impact of the healthy worker effect in active duty on MetS prevalence" which followed with their separation of active and nonactive duty populations for analyses (Herzog et al, 2015). Although the nonactive duty sample was not representative of the nonactive population, the study importantly reported that trends of prevalence which still elucidate the percentages of the populations exceeding various MetS component thresholds which the researchers hope will lend to future "effective prevention, intervention, and disease management strategies" (Herzog et al, 2015).…”

“…Their 2015 report of enrolled Military Health System adults categorized three populations of nonactive duty, active duty, and Air Force duty in an effort to provide values of MetS components representative of each respective population. The active duty sample was the only group that had all five components (BMI or WC, blood glucose, TG, HDL-C, and BP)measured which complicates our means of comparison as the nonactive duty population would be a more similar group to our own(Herzog et al, 2015) Herzog et al (2015). report MetS component prevalence stating that the active duty population completes a medical evaluation before entry, with conditions including diabetes and obesity grounds for disqualification for US military service; the resulting "selection bias" in the active duty subpopulation lead these researchers to stratify their statistical analyses by active and nonactive duty populations.In discussion, Herzog et al (2015) summarize their findings as a decreasing trend in MetS prevalence in the active duty sample between 2009 and 2012.…”