Metabolic syndrome in China.

To the Editor: The recent Mini-Review: Expert Opinions series of articles on the metabolic syndrome epidemic published in the September 30, 2003, issue of Circulation1–3 prompted me to write this letter to the editor. Barely 15 years since the original description by Reaven,4 who called it “syndrome X,” the metabolic syndrome epidemic has already spread to China. The prevalence of metabolic syndrome in China is 13.3% (12.7% in males and 14.2% in females).5 The occurrence of diabetes and other cardiovascular risk factors that constitute the metabolic syndrome is a common phenomenon in modern China.6 The incidence of cardiovascular disease in the metabolic syndrome is high in a study of 27 739 subjects from 11 provinces in China.5 The prevalence of diabetes, impaired glucose regulation, and metabolic syndrome increased progressively in association with a body mass index 23.7 The Chinese have a low baseline body mass index to begin with (baseline value, 21; mean, 18.5 to 23.9), and it takes a smaller increment to reach an obese level by Western criteria.8 China is in the midst of an obesity epidemic.8 Obesity is the principal reason for the increased prevalence of metabolic syndrome in China.5,7,8 Tsung O. Cheng, MD Department of Medicine George Washington University Medical Center Washington, DC