Introduction: Metabolic Syndrome (MetS), characterized by high blood pressure, central obesity, high blood glucose, low HDL cholesterol, and high triglycerides, increases the risk of cardiovascular disease and type 2 diabetes, which are major health issues for African Americans. Pre-metabolic Syndrome (PreMetS) offers a critical window for intervention to prevent MetS. This study estimated PreMetS prevalence among non-Hispanic Black adults, exploring differences by sex and other factors.

Methods: Data from the NHANES 2017-2020 cycle were used, defining PreMetS as the presence of two of the following risk factors: high blood pressure, central obesity, elevated blood glucose, low HDL cholesterol, and high triglycerides.

Findings: The prevalence of PreMetS was 40.4% among non-Hispanic Black adults, with a higher prevalence in women (58%) compared to men (42%). Additionally, PreMetS was more common in individuals aged 40 and older. Men had higher rates of elevated triglycerides (27.6% vs. 17.5%) and high blood glucose (34.0% vs. 20.4%), while women had higher rates of low HDL cholesterol (20.4% vs. 27.6%) and abdominal obesity (62.5% vs. 27.6%). BMI was significantly associated with PreMetS risk in women, with higher odds for those who were overweight (OR 5.42, 95% CI: 1.57-18.68) or obese (OR 3.83, 95% CI: 1.33-11.02).

Conclusion: In summary, the study found a 40% prevalence of PreMetS among non-Hispanic Black adults, with women showing higher rates than men. Elevated blood pressure was more common in men, while abdominal obesity was significantly more prevalent in women. These findings highlight the need for effective public health strategies to prevent the onset of metabolic syndrome in both genders.