Abstract
BACKGROUND: Metabolic syndrome (MetS) is a cluster of risk factors that increase the risk of cardiovascular disease and type 2 diabetes. We aim to investigate the prevalence of MetS based on four prevalent criteria and its associated factors among Tehran's adult residents. METHODS: We utilized the data from the enrollment phase of the Tehran Cohort Study (TeCS). We included the demographic, anthropometric, and biomedical data of 8,232 adult Tehran residents. MetS was defined using four criteria: World Health Organization (WHO), Adult Treatment Panel III (ATP III), International Diabetes Federation (IDF), and Joint Interim Statement (JIS). Sex and age-adjusted prevalence estimates and associated factors were analyzed using regression models. RESULTS: The Participants' mean age was 53.7 ± 12.72 years, and 54% were women. The sex and age-adjusted prevalence of MetS varied depending on the diagnostic criteria used, with the highest rates reported using the JIS criteria (59.3%), followed by the IDF criteria (46.8%), ATP-III (27.1%), and WHO criteria (11.0%). The prevalence generally increased with age across all criteria in both females and males. Females had a higher prevalence than males, except for the WHO and JIS criteria. Factors associated with higher odds of MetS included older age, female gender, lower education level, and low physical activity level. Tobacco use and opium use were associated with lower odds of MetS based on IDF and JIS criteria. CONCLUSION: MetS is highly prevalent among Tehran adults, with notable variation based on diagnostic criteria. Preventive efforts should address modifiable lifestyle factors. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-025-01708-3.