A cross-national comparative study of metabolic syndrome among non-diabetic Dutch and English ethnic groups

Background: Evidence suggests a higher prevalence of type 2 diabetes (T2D) in The Netherlands than in England, although generalized obesity prevalence is substantially lower in The Netherlands. Metabolic syndrome (MS) is more strongly associated with the risk of progression to T2D than generalized obesity. Therefore examining MS may help to better understand the differences in T2D between the two countries. We assessed whether the Dutch and English differences in T2D prevalence reflect similar differences in MS in Whites, South-Asian Indians and African-Caribbeans living in these two countries. Methods: Secondary analyses of population-based studies of 3010 participants aged 35–60 years. Metabolic syndrome was defined according to the International Diabetes Federation criteria. Prevalence ratios (PRs) were estimated using regression models. Results: In general, the Dutch ethnic groups had a higher prevalence of MS than their English counterparts. Adjusted PRs were 1.37[95% confidence interval (CI)1.03–1.82] and 1.52 (1.06–2.19) in White-Dutch men and women compared to White-English men and women; 2.20 (1.14–4.26) and 1.46 (0.96–2.24) in Dutch-African-Caribbean men and women compared to English-African-Caribbean men and women and 0.97 (0.74–1.27) and 1.42 (1.00–2.03) in Dutch-Indian men and women compared with their English-Indian peers, respectively. Similar patterns were also observed for some MS components, e.g. raised fasting glucose in men and central obesity in women. Conclusion: The comparatively high prevalence of MS among Dutch ethnic groups may contribute to their high prevalence of T2D. The high levels of some MS components, e.g. raised fasting glucose in men and central obesity in women add to the high prevalence of MS in Dutch ethnic groups.