Prevalence, component patterns, and lifestyle correlates of metabolic syndrome among civil servants undergoing routine health examinations in Guangzhou, China: a cross-sectional study

Introduction: Metabolic syndrome (MetS) is an important cardiometabolic risk condition among working-age adults, but evidence on its burden, component patterns, and lifestyle correlates among office-based occupational populations in southern China remains limited. Methods: This cross-sectional study identified 22,156 adults undergoing routine health examinations in Guangzhou, China, in 2023. Primary descriptive and multivariable analyses were conducted among 11,291 participants with complete biochemical, anthropometric, and questionnaire data. MetS was defined according to the International Diabetes Federation 2005 criteria. Multiple imputation by chained equations was performed as a sensitivity analysis using the full eligible cohort, and a fully adjusted BMI-adjusted model was additionally fitted within the imputed datasets. Results: In the complete-case sample, MetS prevalence was 13.8%. Elevated blood pressure was the most frequent abnormal component, followed by elevated triglycerides, elevated fasting glucose, central obesity, and reduced HDL-C. In the primary complete-case multivariable analysis, sufficient physical activity was inversely associated with MetS (OR = 0.85, 95% CI: 0.75-0.96). This association was consistent in the multiple-imputation sensitivity analysis (OR = 0.80, 95% CI: 0.72-0.89) and in the fully adjusted BMI-adjusted sensitivity model (OR = 0.80, 95% CI: 0.70-0.91). Discussion: MetS was common in this occupational routine-examination cohort. Elevated blood pressure was the most frequent abnormal component, and physical activity was the most consistent lifestyle correlate. These findings support workplace-based physical activity promotion and cardiometabolic risk management as potential priorities for similar office-based occupational populations.