Association of Health Literacy with Components of Metabolic Syndrome Among Adults in Southwestern Districts of Bangladesh

Background: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that increases the risk of cardiovascular disease and type 2 diabetes. Health literacy (HL) influences health behaviors, disease prevention, and management. Despite high MetS prevalence in Bangladesh, the relationship between HL and MetS components remains underexplored. This study assessed the association between HL and MetS among adults in southwestern Bangladesh (Kushtia, Jhenaidah, Magura).

Methods: A community-based cross-sectional study was conducted among 427 adults aged ≥18 years, selected using multistage random sampling. Sociodemographic data, anthropometry, blood pressure, and fasting blood samples for glucose and lipid profiles were collected. HL was assessed using the validated Bengali HLS-EU-Q16 questionnaire. MetS was defined according to NCEP-ATP III criteria. Bivariate analyses (chi-square, ANOVA) and multivariate logistic regression were performed to examine associations between HL and MetS components, adjusting for age, sex, and education. A p-value <0.05 was considered significant.

Results: The overall prevalence of MetS was 32.5%. Adequate HL was observed in 41% of participants. Participants with inadequate HL had a higher prevalence of central obesity (68% vs 42%), elevated fasting glucose (46% vs 26%), and high triglycerides (49% vs 29%) compared to those with adequate HL (p<0.01). Multivariate logistic regression confirmed significant associations between inadequate HL and central obesity (aOR 2.1, 95% CI 1.4–3.1), elevated fasting glucose (aOR 1.8, 95% CI 1.2–2.8), and high triglycerides (aOR 1.9, 95% CI 1.3–2.9). No significant association was found with hypertension or low HDL-C.

Conclusion: Low HL is significantly associated with key components of MetS. Community-based interventions to improve HL may help reduce MetS prevalence and improve metabolic health in southwestern Bangladesh.