Recommendations for screening of MetS: Utilizing total cholesterol for trend and prevalence estimates of Metabolic Syndrome among adults-findings from STEPS survey of Nepal

The global prevalence of Metabolic Syndrome (MetS)is rising, underscoring the significant burden of cardiovascular morbidity and mortality. Most studies on MetS focus on clinical aspects however, to reduce the burden of cardiovascular disease, periodic screening for MetS is essential along with cost-effective measures that can be implemented on a community basis. The study was a population-based retrospective cross-sectional STEPwise surveillance (STEPS) conducted in three ecological regions of Nepal in 2013 and 2019.A multistage cluster sampling technique was employed to select the sample. Altogether 3473 and 5051 participants were selected from 2013 and 2019 STEPS survey data. Anthropometric measurements, blood pressure readings and fasting blood test for chemical analysis were collected. A conventional measurement criterion was used to determine the prevalence of MetS utilizing Total Cholesterol. Data analysis was performed using STATA version 16.1. ROC curve model, bivariate and multivariate logistic regression model was used for analysis. The results indicated a decline in the prevalence of MetS from 14.1% in 2013 to 6.69% in 2019. However, MetS remains prevalent. The overall prevalence of MetS was 6.69% with women affected nearly twice as often as men (8.62% compared to 4.57%). Significant differences in MetS prevalence were observed based on age, sex, educational level, marital status, wealth quintile and ecological region. High Waist Circumference among women and hypertension among men was prevalent component in MetS. The prevalence and components of MetS among women are significant. Women are at risk for developing MetS indicating an urgent need for lipid profile screening and educational programs aimed at enhancing women's lifestyle choices. Cost-effective screening measures for MetS are recommended utilizing Total Cholesterol. The current health Plan should consider incorporating MetS screening into the World Health Organization's Package of Essential Non-communicable diseases modules to reduce the burden of cardiovascular disease.