as many countries struggle to control infectious diseases , they also face an escalation of chronic diseases  a situation for which they have neither the resources , personnel nor the health service infrastructure required to respond effectively . of the 57 million deaths that occurred around the world in 2008 , 36 million - almost two - thirds - were due to ncds , comprising mainly cardiovascular diseases ( cvd ) , cancers , diabetes , and chronic lung diseases . metabolic syndrome ( ms ) is characterized by a cluster of risk factors , which predisposes subjects to an increased risk of diabetes and cvd . the main components of the syndrome are glucose intolerance , obesity , raised blood pressure ( bp ) , and dyslipidemia . it is increasingly attracting the attention of international research institutions and scientific societies , as a major modifiable determinant of cvd and type 2 diabetes . the criteria employed in this study are those given by international diabetes federation ( idf ) . apart from its association with cardiovascular disorder and diabetes mellitus , ms is also linked to various other morbidities . the risk for several cancers increases in subjects affected by ms . several studies have found that there is a significant association of ms with pancreatic , colorectal , prostatic and breast cancer . in recent years , a lot of work has been done on ms , but most have been confined to hospitals . therefore , this study was conducted to assess its prevalence in a rural adult population of ambala district , haryana , and determine various biochemical and sociodemographic factors associated with the syndrome . a community - based cross - sectional design was adopted for the study of the prevalence of ms . as the data on the prevalence rate of ms for haryana state is not available , the sample size was calculated by presuming its prevalence to be 26% ( mean reported prevalence in india 18% [ deepa et al . ] 10 - 34% [ kanjilal et al . ] ) the sample size for the study arrived at was 1138 , using the formula . the equation for calculating sample size was as follows : z = level of confidence ( 1.96 ) p = prevalence of the disease to compensate for the nonresponse , a survey of 1200 individuals was conducted . the study of a rural population of ambala district was conducted from january 2010 to june 2011 . a multi - stage cluster sampling technique was employed to draw the required sample size . ambala district has six blocks : namely - ambala i , ambala ii , saha , naraingarh , barara and shahzadpur . in the first stage , one of the six blocks in the district , namely barara was selected by simple random sampling . further , in the second stage , a simple two - stage cluster sampling method was adopted . all the family members of the selected households satisfying the inclusion criterion were part of the study . the study included both males and females in the age group of 20 years and above , but pregnant women were excluded . a written informed consent was obtained after the objectives were explained . the clinical definition given by the idf central obesity ( waist circumference 90 cm in men and 80 cm in women ) ; plus any two of the following four factors : 
 raised triglycerides level : 150 mg / dl or specific treatment for this lipid abnormalityreduced high - density lipoprotein cholesterol : < 40 mg / dl in males and < 50 mg / dl or specific treatment for this lipid abnormalityraised bp : systolic bp  130 or diastolic bp 85 mm hg or treatment for previously diagnosed hypertensionraised fasting plasma glucose 100 mg / dl ( 5.6 mmol / l ) or previously diagnosed type 2 diabetes . raised triglycerides level : 150 mg / dl or specific treatment for this lipid abnormality reduced high - density lipoprotein cholesterol : < 40 mg / dl in males and < 50 mg / dl or specific treatment for this lipid abnormality raised bp : systolic bp  130 or diastolic bp 85 mm hg or treatment for previously diagnosed hypertension raised fasting plasma glucose 100 mg / dl ( 5.6 mmol / l ) or previously diagnosed type 2 diabetes . to study the risk factors of ms , the world health organization 's stepwise approach to surveillance ( steps ) proforma was adopted . anthropometric measurements such as height , weight , and waist circumference were measured using standard guidelines . after 5 min rest , three readings of bp were taken with an interval of 2 min between readings and a mean of the three was taken as the final reading . an overnight fasting blood sample ( 10 ml ) was collected . the eligible population was contacted twice for data collection . in the first visit , information about risk factors was taken by the interview technique ( as specified in steps questionnaire ) followed by anthropometry . if the central obesity was found to be more than the prescribed cut - off guideline given by the idf , the participants were asked for their fasting blood samples . informed , written consent was taken from participants before the interview , general physical examination and the collection of blood samples . ethical clearance was obtained from the ethics review committee of maharishi markandeshwar university , mullana , before the conduct of the study . data were analyzed using spss 17.0 ( spss inc . , chicago , il , usa ) . the eligible population was contacted twice for data collection . in the first visit , information about risk factors was taken by the interview technique ( as specified in steps questionnaire ) followed by anthropometry . if the central obesity was found to be more than the prescribed cut - off guideline given by the idf , the participants were asked for their fasting blood samples . informed , written consent was taken from participants before the interview , general physical examination and the collection of blood samples . ethical clearance was obtained from the ethics review committee of maharishi markandeshwar university , mullana , before the conduct of the study . data were analyzed using spss 17.0 ( spss inc . , chicago , il , usa ) . a total of 110 ( 9.2% ) subjects out of 1200 were found to have ms . the highest number of ms cases were found in the age group of > 65 year olds ( 43.6% ) , while the lowest was in those aged 20 - 34 ( 6.4% ) . ms was found to be highest in graduates ( 15.5% ) , while it was lowest in illiterates ( 5.3% ) . the level of education was found to be significantly associated with the prevalence of ms ( p = 0.012 ) [ table 1 ] . prevalence of ms according to sociodemographic variables prehypertensive participants constituted 27.9% of the study population . more than half ( 53.63% ) of the ms cases had concomitant hypertension . about 27.74% of the study population had stages 1 and 2 hypertension . the association of ms and hypertension was found to be statistically significant ( p < 0.01 ) [ table 2 ] . the mean waist circumference in participants with ms was 89.37  8.9 . the majority ( 50.90% ) of the participants who had ms had a waist circumference of 100 cm or above . most cases ( 88.8% ) of ms had fasting blood sugar levels between 150 and 200 mg / dl . about 6.36% cases of ms had fasting blood glucose ( fbg ) levels below 100 mg / dl . the mean fbg was 100.71  45.80 in the ms group as compared to 78.04  24.66 in the non - ms group and this difference was found to be statistically significant ( p < 0.01 ) [ table 4 ] . prevalence of ms and concomitant hypertension prevalence of ms depending on waist circumference prevalence of ms depending on fbg levels in this study , the overall prevalence of ms was 9.2% among individuals aged 20 years and above , in the rural part of ambala district of haryana state . several studies in india have shown different rates of prevalence in different parts of the country . found the prevalence of ms in a south indian population to be 25.8% by idf when compared to 18.3% by adult treatment panel - iii ( atp - iii ) . concluded that the prevalence of ms ( by atp - iii ) was 40.3% when compared to 34.9% by the idf definition . gupta et al . estimated the prevalence in bhatia community in rajasthan by the atp - iii definition to be 36.2% in males and 47.8% in females . the indian council of medical research ( icmr ) task force collaborative study reported the prevalence of ms as 30% in the urban areas of delhi and 11% in rural haryana using atp - iii criteria . similar results were found in another study conducted by kamble et al . in a rural area of wardha district of maharashtra . in that study , the prevalence rates of ms reported by mangat et al . , pemminati et al . and kaur et al . were much higher at 47.5% , 29.7% , and 41.3% respectively . the observed difference could be explained by the fact that all these studies were conducted in urban areas of india while the present study was in rural india . cabr et al . estimated the prevalence by various definitions in spain and reported a prevalence of 35% according to idf . the rate estimated in another study by harzallah et al . in an arab population was 45.5% . the difference in the results of various studies can be attributed to different classifications used to define ms , the composition of the study population , variation in the age groups on which these studies are conducted and differences in the study areas . in this study , the highest number of cases ( 43.6% ) of ms was found in the 65 years and above age group while the lowest ( 6.4% ) was in the age group of 20 - 34 year olds . this finding was in accord with the study conducted by kanjilal et al . in bangalore . similar trends were also reported in a study of the prevalence done by taylor et al . in an african - american population of 21 - 94 year olds in which the highest prevalence was seen in the age group of 65 - 74 year olds and lowest in 21 - 34 year olds . this finding agrees with the results of the study conducted by mangat et al . who documented that using idf , the prevalence of ms was more prevalent among females ( 59.6% ) than males ( 40.4% ) . similar results were reported in studies conducted by pemminati et al . , sidorenkov , kamble et al . , parale et al . and gupta et al . whose results showed a higher prevalence of ms in females than males . the prevalence of ms is on the rise even in rural areas because of the changes in their lifestyles . india has already become the diabetic capital of the world and other ncds are also on the rise . in order to slow down this progression , we need to conduct multi - centric studies to assess the national prevalence of ms .
introduction : metabolic syndrome ( ms ) is a state of deranged metabolic and anthropometric status . 
 it is considered a precursor to various cardiovascular and metabolic diseases.objectives:(1 ) to determine the prevalence of ms in adults aged 20 years and above in the rural area of ambala district , haryana . 
 ( 2 ) to determine the sociodemographic factors associated with ms.materials and methods : in a community - based cross - sectional study , a total of 1200 subjects aged 20 years and above were studied , using multi - stage random sampling.results:the prevalence of ms was estimated by using criterion given by the international diabetes federation . 
 ms was found in 110 ( 9.2% ) subjects , being more prevalent in females : 73 ( 66.36% ) when compared to 37 males ( 33.63% ) . 
 sedentary occupation and age were significantly associated with ms.conclusions:ms is a major health problem in the region and it should be given proper attention in order to prevent and control it .