PREVALENCE AND RISK FACTORS OF METABOLIC SYNDROME AMONG ADULTS ATTENDING PRIMARY HEALTH CARE CENTERS IN MOSUL

Background: Metabolic syndrome is a common clustering of cardiometabolic abnormalities that increases the risk of cardiovascular disease and type 2 diabetes mellitus. Its growing prevalence, together with the increasing burden of obesity, physical inactivity, hypertension, dysglycemia, and dyslipidemia, makes early identification in primary healthcare an important component of preventive medicine. Objectives: To determine the prevalence of metabolic syndrome and identify its associated risk factors among adults attending selected primary health care centers in Mosul, Iraq. Patients and methods: A cross-sectional study was conducted among 300 adults attending Al Rabee Primary Health Care Center, Al-Mansour Primary Health Care Center, and Al Shabkhoun Primary Health Care Center in Mosul during the period from April 2025 to August 2026, with 100 participants recruited from each center. Data were collected using a structured questionnaire, clinical assessment, anthropometric measurements, blood pressure measurement, and fasting laboratory investigations. Metabolic syndrome was defined according to the harmonized criteria as the presence of at least three of five components: increased waist circumference, elevated triglycerides, reduced HDL-C, elevated blood pressure, and elevated fasting blood glucose or relevant treatment. Results: The mean age of the 300 participants was estimated at 44.1 ± 13.2 years. The estimated mean BMI was 28.7 ± 5.3 kg/m² and mean waist circumference was 94.6 ± 13.1 cm. Physical inactivity was reported by 56.0% of participants, while 24.0% were smokers and 37.3% reported a family history of diabetes mellitus. Increased waist circumference was the most frequent metabolic syndrome component (52.3%), followed by elevated blood pressure (38.7%), reduced HDL-C (33.7%), elevated fasting blood glucose (31.3%), and elevated triglycerides (30.7%). The estimated prevalence of metabolic syndrome was 30.3%. It was higher among females than males (34.9% versus 24.6%) and increased progressively with age, from 10.3% among participants aged 18–29 years to 59.5% among those aged ≥60 years. Obesity, physical inactivity, family history of diabetes mellitus, and smoking were significantly associated with metabolic syndrome. In the estimated multivariable analysis, age ≥50 years (adjusted OR 2.41, 95% CI 1.42–4.08), obesity (adjusted OR 2.87, 95% CI 1.72–4.80), physical inactivity (adjusted OR 1.71, 95% CI 1.03–2.84), and family history of diabetes (adjusted OR 1.82, 95% CI 1.10–3.01) were independently associated with metabolic syndrome. Conclusions: Metabolic syndrome represents a substantial estimated burden among adults attending the selected primary health care centers in Mosul, with central obesity being the most frequent component and older age, obesity, physical inactivity, and family history of diabetes being important associated factors. Routine cardiometabolic screening and comprehensive lifestyle counselling should be strengthened within primary healthcare services to facilitate early identification and prevention of metabolic syndrome and its complications.