Table 1.
Trends in prevalence of metabolic syndrome among US adults from 1999 to 2018
| Characteristics | 1999–2000 (n = 1948) | 2001–2002 (n = 2187) | 2003–2004 (n = 1945) | 2005–2006 (n = 2005) | 2007–2008 (n = 2406) | 2009–2010 (n = 2564) | 2011–2012 (n = 2245) | 2013–2014 (n = 2362) | 2015–2016 (n = 2263) | 2017–2018 (n = 2189) | AAPC | P for trend | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Total | 28.23(25.85,30.60) | 29.64(27.35, 31.93) | 30.27(27.45, 33.08) | 29.10(26.19, 32.02) | 29.52(27.28, 31.77) | 29.92(27.00, 32.85) | 30.78(27.66, 33.89) | 32.79(30.11, 35.48) | 34.25(31.15, 37.36) | 37.09(33.66, 40.51) | 1.385(0.778, 1.996) | < 0.001 | |
| Age (years) | |||||||||||||
| 20–44 | 17.94(14.60, 21.27) | 16.49(14.20, 18.78) | 17.90(15.26, 20.55) | 16.51(13.53, 19.48) | 16.56(13.04, 20.07) | 16.27(12.13, 20.40) | 15.82(12.20, 19.44) | 18.34(15.01, 21.66) | 19.51(15.21, 23.82) | 20.49(16.53, 24.45) | 1.015(−0.195, 2.239) | 0.100 | |
| 45–64 | 36.75(31.46, 42.04) | 40.30(35.59, 45.00) | 38.55(33.86, 43.25) | 34.83(30.04, 39.62) | 34.99(31.86, 38.13) | 36.39(33.17, 39.62) | 37.49(31.03, 43.95) | 40.24(35.40, 45.09) | 41.10(35.39, 46.80) | 42.50(35.98, 49.03) | 0.457(−0.721, 1.650) | 0.448 | |
| ≥65 | 50.78(43.17, 58.40) | 53.12(47.25, 59.00) | 52.19(46.40, 57.98) | 52.82(46.30, 59.34) | 54.07(46.88, 61.27) | 52.96(48.77, 57.16) | 57.57(49.91, 65.23) | 55.62(49.81, 61.44) | 54.80(50.14, 59.45) | 63.02(58.30, 67.75) | 0.968(0.251, 1.690) | 0.008 | |
| Sex | |||||||||||||
| Female | 30.14(27.94, 32.35) | 29.59(26.73, 32.46) | 29.48(24.87, 34.10) | 28.10(23.55, 32.66) | 30.11(26.97, 33.24) | 28.70(25.40, 31.99) | 30.48(26.56, 34.41) | 32.83(29.13, 36.54) | 32.46(28.44, 36.47) | 35.58(31.46, 39.70) | 0.223(−0.821, 1.279) | 0.124 | |
| Male | 26.17(21.92, 30.42) | 29.70(25.96, 33.43) | 31.07(26.76, 35.37) | 30.18(26.99, 33.37) | 28.91(25.88, 31.94) | 31.19(26.23, 36.15) | 31.08(27.61, 34.55) | 32.75(29.54, 35.97) | 36.16(31.91, 40.40) | 38.65(33.82, 43.49) | 1.269(−0.345, 2.909) | 0.676 | |
| Race and ethnicity | |||||||||||||
| Non-Hispanic white | 28.32(24.84, 31.80) | 30.14(27.94, 32.34) | 32.29(28.26, 36.32) | 30.70(27.00, 34.40) | 31.00(27.41, 34.60) | 30.64(27.26, 34.03) | 31.62(27.58, 35.65) | 35.24(31.71, 38.76) | 36.41(32.26, 40.55) | 38.33(33.42, 43.24) | 1.438(0.493, 2.392) | 0.003 | |
| Non-Hispanic black | 21.42(17.67, 25.17) | 27.05(22.16, 31.94) | 21.73(17.70, 25.75) | 26.43(22.03, 30.84) | 26.49(19.36, 33.63) | 29.96(23.83, 36.10) | 30.33(26.85, 33.81) | 29.70(24.20, 35.20) | 28.24(25.17, 31.31) | 29.59(24.53, 34.65) | 1.333(−1.272, 4.007) | 0.319 | |
| Mexican American | 25.36(18.04, 32.68) | 27.90(21.85, 33.94) | 28.21(20.67, 35.75) | 24.72(18.16, 31.28) | 28.23(24.18, 32.28) | 32.36(27.04, 37.69) | 32.92(25.80, 40.03) | 29.32(23.90, 34.73) | 36.91(32.04, 41.77) | 40.64(35.33, 45.96) | 2.580(0.771, 4.422) | 0.005 | |
| Other Hispanic | 35.07(27.78, 42.36) | 31.57(10.54, 52.60) | 17.57(2.47, 32.68) | 19.18(9.75, 28.61) | 26.25(21.43, 31.06) | 28.00(24.09, 31.91) | 29.64(23.47, 35.81) | 26.24(19.37, 33.11) | 28.79(22.37, 35.21) | 34.42(25.43, 43.41) | −0.494(−6.343, 5.721) | 0.873 | |
| Other race | 33.24(16.27, 50.21) | 28.45(16.59, 40.30) | 29.83(20.67, 38.99) | 26.22(11.06, 41.38) | 21.85(13.22, 30.47) | 20.76(11.66, 29.86) | 22.75(14.30, 31.19) | 25.18(19.59, 30.78) | 28.41(22.08, 34.74) | 35.94(28.00, 43.87) | −0.068(−1.850, 1.745) | 0.941 | |
| Marital status | |||||||||||||
| No | 27.11(21.98, 32.24) | 26.86(21.96, 31.75) | 27.17(22.79, 31.54) | 22.98(19.55, 26.41) | 27.14(23.64, 30.65) | 28.40(23.76, 33.04) | 27.93(23.97, 31.89) | 30.15(25.36, 34.94) | 31.54(27.81, 35.27) | 32.67(29.63, 35.70) | 0.938(0.319, 1.561) | 0.003 | |
| Yes | 29.44(24.84, 34.04) | 31.44(28.79, 34.09) | 32.60(28.60, 36.60) | 33.50(29.22, 37.78) | 31.28(28.11, 34.45) | 30.92(27.55, 34.30) | 33.16(29.35, 36.97) | 34.76(30.87, 38.65) | 36.40(32.04, 40.76) | 41.14(35.57, 46.71) | 1.428(0.263, 2.606) | 0.016 | |
| Education level | |||||||||||||
| Less than high school | 31.83(25.07, 38.58) | 39.47(33.23, 45.71) | 31.83(28.05, 35.61) | 35.09(29.51, 40.67) | 38.52(34.02, 43.02) | 40.27(35.81, 44.74) | 36.81(32.61, 41.01) | 38.41(32.90, 43.92) | 38.87(33.13, 44.61) | 46.10(39.42, 52.79) | 1.521(−1.781, 4.933) | 0.371 | |
| High school graduate | 32.35(25.51, 39.20) | 32.34(27.50, 37.18) | 36.23(31.28, 41.18) | 35.85(31.72, 39.98) | 33.89(27.50, 40.29) | 35.76(31.38, 40.14) | 36.88(32.69, 41.08) | 35.76(28.94, 42.58) | 36.54(29.51, 43.56) | 43.21(35.22, 51.19) | 1.229(−0.460, 2.947) | 0.155 | |
| Some college | 31.09(23.31, 38.87) | 24.95(21.61, 28.29) | 28.98(25.53, 32.43) | 29.10(24.83, 33.37) | 27.33(23.13, 31.53) | 31.16(25.62, 36.69) | 30.31(25.04, 35.59) | 36.85(32.79, 40.91) | 35.48(29.68, 41.29) | 36.18(31.79, 40.56) | 1.914(−0.577, 4.468) | 0.133 | |
| College graduate or above | 16.18(10.45, 21.92) | 25.54(21.05, 30.02) | 24.43(18.47, 30.38) | 18.21(12.91, 23.51) | 21.85(17.61, 26.10) | 17.41(13.44, 21.38) | 24.07(18.18, 29.97) | 23.76(19.39, 28.13) | 29.38(23.14, 35.62) | 28.83(24.31, 33.36) | 1.234(−2.484, 5.093) | 0.521 | |
| Insurance status | |||||||||||||
| Uninsured | 24.50(17.25, 31.75) | 15.79(11.41, 20.17) | 24.20(18.43, 29.97) | 20.57(14.72, 26.41) | 22.75(18.41, 27.09) | 24.21(19.38, 29.03) | 24.91(21.08, 28.74) | 21.79(17.97, 25.61) | 26.92(22.57, 31.27) | 27.90(20.64, 35.17) | 1.788(−2.588, 6.360) | 0.429 | |
| Any Insurance | 29.29(26.47, 32.11) | 32.49(30.10, 34.88) | 31.63(28.59, 34.66) | 31.11(27.87, 34.35) | 31.01(28.06, 33.95) | 31.52(28.07, 34.98) | 32.25(28.77, 35.74) | 35.22(31.73, 38.71) | 35.36(31.73, 38.98) | 38.56(35.25, 41.87) | 1.137(0.094, 2.191) | 0.033 | |
| Income-to-poverty ratio | |||||||||||||
| < 1 | 28.30(23.14, 33.47) | 32.63(23.86, 41.41) | 24.29(19.43, 29.15) | 32.63(22.23, 43.03) | 32.08(27.58, 36.58) | 28.48(23.80, 33.15) | 28.35(23.77, 32.94) | 34.74(29.41, 40.07) | 33.01(26.88, 39.14) | 36.23(30.93, 41.53) | 1.401(−1.158, 4.026) | 0.286 | |
| 1–2 | 31.77(25.83, 37.71) | 29.53(23.45, 35.60) | 33.84(30.00, 37.69) | 33.17(26.91, 39.43) | 34.95(30.22, 39.68) | 34.15(28.41, 39.90) | 35.95(30.57, 41.34) | 36.10(30.65, 41.54) | 34.08(30.28, 37.88) | 41.01(35.73, 46.28) | 1.064(0, 2.140) | 0.050 | |
| 2–3.5 | 34.25(26.73, 41.77) | 29.11(22.82, 35.40) | 31.86(26.66, 37.06) | 29.14(22.73, 35.56) | 28.30(23.81, 32.79) | 31.92(26.13, 37.72) | 32.60(26.38, 38.82) | 32.67(26.75, 38.59) | 36.03(29.90, 42.16) | 40.84(35.60, 46.08) | 1.035(− 0.587, 2.683) | 0.212 | |
| ≥3.5 | 23.49(18.72, 28.25) | 28.61(25.97, 31.25) | 28.62(22.66, 34.58) | 26.09(22.79, 29.39) | 27.49(24.55, 30.43) | 26.48(21.82, 31.15) | 27.48(21.50, 33.45) | 31.04(26.79, 35.28) | 33.76(27.20, 40.32) | 33.03(27.45, 38.60) | 1.22(−0.807, 3.288) | 0.240 | |
| Alcohol | |||||||||||||
| No | 36.41(32.01, 40.82) | 38.58(30.91, 46.25) | 38.64(34.94, 42.35) | 37.73(31.64, 43.82) | 35.01(30.96, 39.06) | 40.33(35.62, 45.04) | 38.64(32.89, 44.39) | 40.66(35.10, 46.21) | 39.30(35.82, 42.78) | 42.37(32.56, 52.18) | 0.473(−0.314, 1.267) | 0.240 | |
| Yes | 25.44(22.78, 28.10) | 26.51(23.65, 29.37) | 27.75(24.55, 30.96) | 26.01(22.84, 29.18) | 27.60(24.86, 30.33) | 27.80(24.43, 31.16) | 30.31(26.61, 34.02) | 31.17(28.71, 33.63) | 32.97(29.42, 36.51) | 36.91(33.37, 40.44) | 1.859(1.045, 2.678) | < 0.001 | |
| Smoking status | |||||||||||||
| Never smoker | 26.74(22.34, 31.14) | 27.26(23.29, 31.23) | 28.63(24.55, 32.71) | 26.40(22.45, 30.35) | 25.94(22.94, 28.94) | 27.62(23.81, 31.43) | 27.19(24.38, 30.01) | 29.61(25.26, 33.96) | 29.80(26.09, 33.50) | 32.93(27.60, 38.26) | 0.996(−0.222, 2.229) | 0.109 | |
| Former smoker | 34.33(29.17, 39.50) | 36.42(30.88, 41.97) | 39.74(34.44, 45.04) | 37.45(32.31, 42.59) | 40.38(36.28, 44.49) | 37.00(32.43, 41.57) | 37.80(30.78, 44.83) | 41.11(37.17, 45.06) | 46.37(40.66, 52.08) | 44.35(38.55, 50.15) | 1.318(−0.245, 2.905) | 0.099 | |
| Current smoker | 24.63(20.61, 28.66) | 27.45(22.87, 32.03) | 24.23(20.16, 28.31) | 26.05(21.77, 30.32) | 25.64(21.44, 29.84) | 27.20(20.60, 33.80) | 32.72(27.77, 37.66) | 31.64(27.78, 35.51) | 29.79(24.53, 35.06) | 39.35(32.81, 45.88) | 2.083(−0.424, 4.652) | 0.104 | |
| Activity | |||||||||||||
| No | 34.95(30.37, 39.53) | 38.41(34.72, 42.11) | 33.03(29.41, 36.65) | 39.00(32.94, 45.06) | 37.75(35.50, 39.99) | 38.69(35.73, 41.65) | 38.72(34.14, 43.30) | 41.64(38.05, 45.23) | 42.29(37.85, 46.73) | 44.53(39.10, 49.97) | 0.971(0.066, 1.884) | 0.035 | |
| Moderate | 32.11(26.03, 38.19) | 33.84(29.48, 38.20) | 39.54(35.72, 43.36) | 31.31(26.15, 36.47) | 34.09(29.06, 39.12) | 31.06(27.28, 34.83) | 33.47(27.61, 39.33) | 33.74(28.37, 39.11) | 37.66(33.61, 41.71) | 39.91(33.93, 45.89) | 0.515(−2.584, 3.713) | 0.956 | |
| Vigorous | 18.37(14.49, 22.26) | 18.14(14.71, 21.57) | 16.96(12.62, 21.29) | 19.31(15.67, 22.95) | 9.70(6.73, 12.66) | 12.08(7.63, 16.52) | 13.72(10.10, 17.35) | 14.28(11.40, 17.17) | 16.11(12.89, 19.33) | 22.29(15.99, 28.59) | 0.158(−5.289, 5.919) | 0.748 | |
| BMI (kg/m2)a | |||||||||||||
| Normal weight (18.5–24.9) | 8.55(4.98, 12.12) | 9.24(6.61, 11.86) | 9.45(7.02, 11.88) | 5.90(4.41, 7.40) | 6.21(4.39, 8.03) | 7.44(5.42, 9.46) | 8.93(6.49, 11.36) | 7.65(4.26, 11.05) | 7.74(5.50, 9.98) | 10.22(7.29, 13.14) | −0.385(−4.565, 3.979) | 0.860 | |
| Overweight (25.0–29.9) | 26.27(23.68, 28.86) | 31.02(28.16, 33.88) | 29.33(24.92, 33.75) | 25.14(19.03, 31.25) | 27.58(23.79, 31.38) | 24.16(21.59, 26.72) | 24.33(20.23, 28.42) | 31.09(27.65, 34.52) | 29.92(25.47, 34.38) | 33.46(28.29, 38.64) | 0.798(−1.936, 3.609) | 0.571 | |
| Obesity (≥30.0) | 57.59(53.18, 62.01) | 51.28(46.73, 55.83) | 53.79(49.27, 58.31) | 55.23(51.10, 59.35) | 55.78(51.90, 59.65) | 54.83(48.40, 61.26) | 55.95(51.54, 60.35) | 54.43(48.98, 59.88) | 55.32(50.41, 60.22) | 58.25(53.06, 63.43) | 0.09(−0.557, 0.740) | 0.787 | |
a 352(underweight) participants with BMI less than 18.5 were not showed; AAPC: average annual rates of change