Cardiovascular disease (CVD) is one of the major causes of death in individuals with spinal cord injury (SCI) and is reported to have a higher prevalence in individuals with SCI than in the general population (GP).1, 2, 3 Metabolic syndrome (MetS) is considered as a cluster of risk factors for CVD, and the accurate diagnosis of MetS contributes to CVD prevention.4,5 MetS is characterized by hypertension, abdominal obesity, hyperglycemia, and dyslipidemia. According to previous studies, the prevalence of MetS in patients with SCI ranged from 23 % to 57 %.6, 7, 8, 9, 10 The higher prevalence of MetS in individuals with SCI can be attributed to their increased susceptibility to abdominal obesity, a major risk factor for MetS. This susceptibility is not only due to decreased physical activity and altered hormone metabolism following SCI, but also involves complex metabolic changes including increased fat infiltration, reduced muscle mass, and insulin resistance.11, 12, 13

In a study by Liang et al.14 that included individuals with and without SCI aged 20–59 years, no significant difference was observed in the prevalence of MetS between individuals with SCI and those in the GP of the same sex and age group. An analysis of comparative studies on MetS between individuals with SCI and the GP by the Agency for Healthcare Research and Quality reported that individuals with SCI were not disproportionately exposed to a higher risk of carbohydrate and lipid disorders or CVD than was the GP.15 In contrast, Maruyama et al.7 reported a higher prevalence of MetS in Japanese men with SCI (43 %) than in non-disabled Japanese men (19.5 %). Such studies are limited by factors such as small sample sizes and the absence of important considerations such as the lack of age-matched control groups.

Diagnosing MetS in individuals with SCI using the waist circumference (WC) set for the GP may result in an underestimation of metabolic abnormalities related to abdominal obesity, and a reduction in opportunities to prevent CVD.13,16, 17, 18 Furthermore, because not all components of MetS can be classified as individual criteria, it is necessary to examine the trends of each component of MetS together and identify their characteristics to implement preventive approaches.19,20

This study aimed to compare large-scale population survey data from male individuals with SCI with non-injured males matched for age to examine the trends in MetS and its components over a 5-year period. Additionally, we compared the prevalence and factors influencing MetS according to the WC threshold in patients with SCI and the GP, aiming to contribute to the understanding of the characteristics and diagnostic criteria of MetS in SCI and to aid in the prevention of CVD.