Social class and metabolic syndrome in populations from Tunisia and Spain.

However, in Tunisian women there was also a significant trend to decrease the MS risk from ICE2 to ICE5 (p < 0.001).

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Excepting the Tunisian men, there is a clear trend of MS frequency an MS risk to decrease when social class increases.

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In Spain, the Canary Islands have a high prevalence of obesity and MS [ 11 , 12 ], and the incidence of diabetes is 1.5-fold higher than in continental Spain [ 13 ]; in this region a decreasing trend of MS when social class increases has been described, with the social being measured by the income, crowding and education (ICE) model [ 14 ].

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