Prevalence and Determinants of Metabolic Syndrome Among Adults (18–60 Years) in Urban and Rural South India: A Community-Based Cross-Sectional Study

Background Metabolic syndrome (MetS) constitutes a multifaceted clinical condition characterised by a constellation of metabolic risk factors including central obesity, atherogenic dyslipidemia, elevated blood pressure, and impaired glucose metabolism, which synergistically elevate the risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Rapid shifts in lifestyle have notably elevated the incidence of MetS in India, particularly in urban regions. Yet, sparse comparative data is available regarding the urban-rural differences in MetS prevalence within Tamil Nadu. Thus, this research sought to assess the prevalence of MetS and to identify associated risk factors among adults residing in urban and rural locales of Tamil Nadu. Methods Employing a multistage random sampling approach, this community-centric cross-sectional study encompassed 1,000 adults, evenly divided between urban (n=500) and rural (n=500) settings. Data were gathered through structured face-to-face interviews, anthropometric assessments, and biochemical analyses. The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guidelines were utilised to define MetS. Analytical methods included descriptive statistics, chi-square tests, independent samples t-tests, and multivariate logistic regression modelling to pinpoint the critical determinants of MetS. Results The cumulative prevalence of MetS was 31.6% (95% confidence interval (CI): 28.7%-34.6%; 316 participants), with a higher prevalence in urban areas at 34.8% (95% CI: 31.9%-37.8%; 174 participants) compared to 28.4% in rural areas (95% CI: 25.6%-31.3%; 142 participants). The study identified significant predictors of MetS, such as age 40 years or above (adjusted odds ratio (AOR): 2.2, p<0.01), female sex (AOR: 2.8, p<0.01), tobacco smoking (AOR: 2.7, p<0.01), sedentary lifestyle (AOR: 2.7, p=0.02), minimal fruit intake (AOR: 4.4, p=0.01), habitual consumption of fried foods (AOR: 5.3, p=0.01), existing diabetes mellitus (AOR: 3.2, p=0.02), and obesity (AOR: 2.3, p=0.03). Conclusion Urban populations exhibited a higher MetS prevalence, likely attributed to modifiable dietary patterns and lifestyle choices. Regular screening initiatives, lifestyle adjustments, and targeted nutritional interventions emerge as vital preventive and therapeutic measures. Public health strategies should emphasise early detection and encourage behavioural modifications, specifically targeting at-risk populations.