Gender as an independent risk factor for the components of metabolic syndrome among individuals within the normal range of body mass index

Background: Overweight and obesity are more common in men than in women. This explains the higher prevalence of risk factors for metabolic syndrome (MetS) found in men. We aimed to assess whether gender, per se, might be an independent risk factor for the components of MetS in a large cohort of subjects within the normal range of body mass index (BMI). Materials and Methods: Cross-sectional analysis was carried out on 9976 men and women, aged 18 to 70 years, with a BMI between 18.5 and 25.0 kg/m² attending a screening center in Israel between the years 2000 and 2014. Results: Mean (SD) age of the study sample was 43.3 (9.6) years, 54.5% were men. Prevalence of MetS components in men and women was hypertension 5.3% and 3.0%, impaired fasting glucose (IFG) 18.1% and 7.9%, diabetes mellitus (DM) 2.4% and 1.3%, high triglyceride levels 17.7% and 9.4%, and low high-density lipoprotein (HDL) cholesterol levels 13.6% and 17.0%, respectively, P < 0.001 for all. Increased waist circumference was <1% in both genders. Multivariate analysis showed male gender to be an independent risk factor for IFG [odds ratio (OR) 2.43, 95% confidence interval (CI) 2.12-2.79], hypertriglyceridemia (OR 1.86, 95% CI 1.63-2.12), DM (OR 1.80, 95% CI 1.29-2.50), and hypertension (OR 1.46, 95% CI 1.16-1.83) but not for low HDL levels (OR 0.59, 95% CI 0.52-0.67). Conclusion: This study, on a cross-sectional sample of subjects with a normal BMI, showed male gender to be an independent risk factor for all components of the MetS, apart from the low HDL risk factor that was found to be higher in women.