Metabolic syndrome and Framingham risk score in obese young adults

  • Felix F. Widjaja
  • Ivan R. Widjaja
  • Yuni Astria
  • Christopher S. Suwita
  • Sarwono Waspadji
Keywords: Abdominal obesity, Framingham risk score, metabolic syndrome, young adults
Abstract viewed: 2100 times
PDF downloaded: 722 times


Background: The increase number of the metabolic syndrome (MetS) among young adults was mostly caused by obesity. MetS increases the risk of coronary heart disease (CHD) which can be estimated by Framingham risk score (FRS). The study was aimed to know the prevalence of MetS and FRS in obese young adults and to associate them with the components of MetS.

Methods: A total of 70 male and female students aged 18-25 years with BMI ≥25 kg/m2 in Faculty of Medicine Universitas Indonesia were selected consecutively. The blood samples used to test fasting blood glucose, total cholesterol, high-density lipoprotein, and triglyceride were examined in Department of Clinical Pathology, Cipto Mangunkusumo Hospital after fasting for 14-16 hours. International Diabetes Federation (IDF) definition was used to diagnose MetS. Univariate and bivariate analysis were done.

Results: The prevalence of MetS based on IDF definition was 18.6% among obese young adults. The most associated MetS components was hypertriglyceridemia (OR 12.13; 95% CI 2.92-50.46; p=0.001), followed with high blood pressure (OR 9.33; 95% CI 2.26-38.56; p = 0.001), low-HDL (OR 8.33; 95% CI 2.17-32.05; p=0.003), and impaired fasting glucose (p=0.03). Four subjects had FRS ≥1% and 66 subjects had risk <1%. Increased FRS was not associated with MetS (p=0.154). There was no component of MetS associated with increased FRS.

Conclusion: Prevalence of MetS in obese young adults was similar with obese children and adolescents. Although no association of MetS and FRS was found, they are significant predictors for CHD which should not be used separately.


Download data is not yet available.


  1. Grundy SM, Brewer HB, Jr., Cleeman JI, Smith SC, Jr., Lenfant C. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004;109(3):433-8.

  2. Einhorn D, Reaven GM, Cobin RH, et al. American College of Endocrinology position statement on the insulin resistance syndrome. Endocr Pract. 2003;9(3):237-52.

  3. Isomaa B, Almgren P, Tuomi T, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001;24(4):683-9.

  4. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143-421.

  5. JBS 2: Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice. Heart. 2005;91 Suppl 5:v1-52.

  6. Network SIG. Risk estimation and the prevention of cardiovascular disease: A national clinical guideline. Edinburgh: Scottish Intercollegiate Guidelines Network; 2007.

  7. Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, May M, Brindle P. Derivation and validation of QRISK, a new cardiovascular disease risk score for the United Kingdom: prospective open cohort study. BMJ. 2007;335:136.

  8. Pocock SJ, McCormack V, Gueyffier F, Boutitie F, Fagard RH, Boissel JP. A score for predicting risk of death from cardiovascular disease in adults with raised blood pressure, based on individual patient data from randomised controlled trials. BMJ. 2001;323:75-81.

  9. Sheridan S, Pignone M, Mulrow C. Framingham-based tools to calculate the global risk of coronary heart disease: a systematic review of tools for clinicians. J Gen Intern Med. 2003;18(12):1039-52.

  10. Wannamethee SG, Shaper AG, Lennon L, Morris RW. Metabolic syndrome vs Framingham Risk Score for prediction of coronary heart disease, stroke, and type 2 diabetes mellitus. Arch Intern Med. 2005;165(22):2644-50.

  11. World Health Organization, International Obesity Task Force and International Association for the Study of Obesity. The Asia-Pacific Perspective: Redefining Obesity and its Treatment. Sydney: Health Communications Australia Pty Ltd; 2000.

  12. Gortmaker SL, Must A, Perrin JM, Sobol AM, Dietz WH. Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med. 1993;329:1008-12.

  13. Bosello O, Zamboni M. Visceral obesity and metabolic syndrome. Obes Rev. 2000;1(1):47-56.

  14. Mattsson N, Ronnemaa T, Juonala M, Viikari JS, Raitakari OT. The prevalence of the metabolic syndrome in young adults. The Cardiovascular Risk in Young Finns Study. J Intern Med. 2007;261(2):159-69.

  15. Weiss R, Dziura J, Burgert TS, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004;350:2362-74.

  16. Alexander CM, Landsman PB, Teutsch SM, Haffner SM. NCEP-defined metabolic syndrome, diabetes, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes. 2003;52:1210-4.

  17. Hunt KJ, Resendez RG, Williams K, Haffner SM, Stern MP. National Cholesterol Education Program versus World Health Organization metabolic syndrome in relation to all-cause and cardiovascular mortality in the San Antonio Heart Study. Circulation. 2004;110:1251-7.

  18. U.S. Department of Health and Human Services: Substance Abuse and Mental Health Services Administration. National Household Survey on Drug Abuse: Main Findings 1996: Office of Applied Studies, Substance Abuse and Mental Health Service Administration, Department of Health & Human Services; 1998.

  19. Ford E. Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the U.S. Diabetes Care. 2005;28(11):2745-9.

  20. Sarti C, Gallagher J. The metabolic syndrome: prevalence, CHD risk, and treatment. J Diabetes Complications. 2006;20(2):121-32.

  21. Mikkola I, Keinanen-Kiukaanniemi S, Laakso M, et al. Metabolic syndrome in connection with BMI in young Finnish male adults. Diabetes Res Clin Pract. 2007;76(3):404-9.

  22. Ervin RB. Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States, 2003â2006. National health statistics reports; no 13. Hyattsville MD: National Center for Health Statistics. 2009.

  23. Nestel P, Lyu R, Low LP, et al. Metabolic syndrome: recent prevalence in East and Southeast Asian populations. Asia Pac J Clin Nutr. 2007;16(2):362-7.

  24. Mohamud WN, Ismail AA, Sharifuddin A, et al. Prevalence of metabolic syndrome and its risk factors in adult Malaysians: results of a nationwide survey. Diabetes Res Clin Pract. 2011;91(2):239-45.

  25. Soewondo P, Purnamasari D, Oemardi M, Waspadji S, Soegondo S. Prevalence of metabolic syndrome using NCEP/ATP III criteria in Jakarta, Indonesia: the Jakarta primary non-communicable disease risk factors surveillance 2006. Acta Med Indones. 2010;42(4):199-203.

  26. Pan WH, Yeh WT, Weng LC. Epidemiology of metabolic syndrome in Asia. Asia Pac J Clin Nutr. 2008;17 Suppl 1:37-42.

  27. Muherdiyantiningsih EF, Effendi R, Herman S. Sindrom metabolik pada orang dewasa gemuk di wilayah Bogor. Penel Gizi Makan. 2008;31:75-81. Indonesia.

  28. Ferguson TS, Tulloch-Reid MK, Younger NO, et al. Prevalence of the metabolic syndrome and its components in relation to socioeconomic status among Jamaican young adults: a cross-sectional study. BMC Public Health. 2010;10:307.

  29. Tailor AM, Peeters PH, Norat T, Vineis P, Romaguera D. An update on the prevalence of the metabolic syndrome in children and adolescents. Int J Pediatr Obes. 2010;5(3):202-13.

  30. Wickham EP, Stern M, Evans RK, et al. Prevalence of the metabolic syndrome among obese adolescents enrolled in a multidisciplinary weight management program: clinical correlates and response to treatment. Metab Syndr Relat Disord. 2009;7(3):179-86.

  31. Reinehr T, Kiess W, Kapellen T, Andler W. Insulin sensitivity among obese children and adolescents, according to degree of weight loss. Pediatrics. 2004;114(6):1569-73.

  32. Ferrannini E, Natali A, Bell P, Cavallo-Perin P, Lalic N, Mingrone G. Insulin resistance and hypersecretion in obesity. European Group for the Study of Insulin Resistance (EGIR). J Clin Invest. 1997;100(5):1166-73.

  33. Zannad F, Jakobsen A, Heroys J, Ralph A, Rees T, Shaw M. Cardiovascular high-risk patients--treat to protect, but whom? Medscape J Med. 2008;10 Suppl:S2.

  34. Berry JD, Lloyd-Jones DM, Garside DB, Greenland P. Framingham risk score and prediction of coronary heart disease death in young men. Am Heart J. 2007;154(1):80-6.

  35. Bansal M, Shrivastava S, Mehrotra R, Agarwal V, Kasliwal RR. Low Framingham risk score despite high prevalence of metabolic syndrome in asymptomatic North-Indian population. J Assoc Physicians India. 2009;57:17-22.

  36. Lee GK, Lee LC, Liu CW, et al. Framingham risk score inadequately predicts cardiac risk in young patients presenting with a first myocardial infarction. Ann Acad Med Singapore. 2010;39(3):163-7.

  37. Soegondo S. Atherogenic dyslipidemia and the metabolic syndrome. Acta Med Indones. 2005;37(3):177-83.

  38. Ghandehari H, Le V, Kamal-Bahl S, Bassin SL, Wong ND. Abdominal obesity and the spectrum of global cardiometabolic risks in US adults. Int J Obes (Lond). 2009;33(2):239-48.

  39. Jaquet A, Deloumeaux J, Dumoulin M, Bangou J, Donnet JP, Foucan L. Metabolic syndrome and Framingham risk score for prediction of cardiovascular events in Caribbean Indian patients with blood glucose abnormalities. Diabetes Metab. 2008;34(2):177-81.

  40. Taslim S, Tai ES. The relevance of the metabolic syndrome. Ann Acad Med Singapore. 2009;38(1):25-9.

  41. McNeill AM, Rosamond WD, Girman CJ, et al. The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study. Diabetes Care. 2005;28(2):385-90.

How to Cite
Widjaja FF, Widjaja IR, Astria Y, Suwita CS, Waspadji S. Metabolic syndrome and Framingham risk score in obese young adults. Med J Indones [Internet]. 2013Jun.1 [cited 2024Jul.21];22(2):100-6. Available from:
Community Research

Most read articles by the same author(s)

1 2 > >>