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Backgrounds and Aims: Evidence on the association between habitual snoring, excessive daytime sleepiness (EDS), and cardiovascular diseases (CVDs) remains uncertain and limited. The study aimed to explore the independent and joint association between habitual snoring, EDS, and CVDs in rural Chinese adults., Methods and Results: A total of 28,140 participants from the Henan rural cohort study were included. Sleep status information was obtained by self-reported. Based on their sleep status, the participants were classified into four groups: "no snoring and no EDS (NSNS) (reference group)", "snoring and no EDS (SNS)", "no snoring and EDS (NSS)", "snoring and EDS (SS)." The logistic regression models were used to calculate independent and joint odds ratios (OR) and 95% confidence intervals (CI) between the snoring, EDS status and stroke, CHD, and CVD. Of the 28,140 participants, 740 subjects reported snoring and sleepiness. The ORs and (95% CIs) for CVDs in the adjusted model were 1.31 (1.20-1.43) for participants who snored frequently and 2.44 (1.76-3.39) for frequent sleepiness compared with no snoring and no sleepiness. Individuals with both snoring and sleepiness had higher odds of CVDs compared with no snoring and no sleepiness (OR: 2.18, 95%CI: 1.80-2.62)., Conclusion: Habitual snoring and excessive daytime sleepiness were independently and jointly associated with CVDs in the Chinese rural population. More studies are needed to explore the mechanisms of the relationship., Clinical Trial Registration: The Henan Rural Cohort Study has been registered at the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-52 07-06. http://www.chictr.org.cn/showproj.aspx?proj=11375., Competing Interests: Conflict of interest The authors declare that they have no conflict of interest., (Copyright © 2023 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Evidence linking sleep timing and night sleep duration to dyslipidemia was limited and inconclusive, especially among low- and middle-income adults. The aims were to evaluate the associations between sleep timing, night sleep duration and dyslipidemia in a rural population. Based on the Henan Rural Cohort Study, a total of 37 164 participants were included. The Pittsburgh Sleep Quality Index was used to collect sleep information. Logistic regression and restrictive cubic splines were conducted to explore the associations. Of the 37 164 enrolled participants, 13881 suffered from dyslipidemia. Compared to the reference groups, people who went to sleep after 23:00 or woke up after 7:30 had higher prevalence of dyslipidemia, the adjusted odds ratios ( ORs ) and 95% confidence intervals ( CIs )were 1.30 (1.20-1.41) and 1.34 (1.19-1.50). The adjusted OR (95% CI ) of participants in the Late-sleep/Late-rise category compared to the Early-sleep/Early-rise category was 1.55 (1.08-1.23). Compared to the reference (7~≤8 h), the adjusted OR (95% CI ) was 1.11 (1.03-1.20) for longer (>9 h) night sleep duration. Moreover, the combined effects of sleep duration (>9 h) with sleep time (22:00~) ( OR  = 1.46, 95% CI : 1.16-1.84), sleep duration (>9 h) with wake-up time (≥7:30) ( OR  = 1.28, 95% CI : 1.08-1.51), and sleep duration (>9 h) with the Late-sleep/Late-rise category ( OR  = 1.41, 95% CI : 1.14-1.75) increased the prevalence of dyslipidemia. Accordingly, our results indicate that delayed sleep timing and longer night sleep duration had independent and joint effects on higher risks of dyslipidemia in rural population.

Background: Inappropriate sleep duration is a potential cause of stroke. But the effect of napping on stroke risk remains controversial and the interaction between night sleep and napping duration remains unclear. The objective of this study was to examine the independent and combined effects of napping and nocturnal sleep duration on stroke., Methods: Subjects were derived from a rural cohort study in Henan. The Pittsburgh Sleep Quality Index (PSQI) was applied to identify nap duration and nocturnal sleep duration. Binary logistic regression was employed to indicate the dose-response relationships between naps, nocturnal sleep, total 24-h sleep duration, and stroke., Results: Among the 37,341 participants (14,485 men), 2600 suffered from a stroke. The odds ratios (ORs) and 95% confidence level (CI) for stroke in the fully adjusted model were 1.37 (1.13-1.65) for men nappers compared to non-nappers. Compared to 7-8 h of sleep per day, night sleep durations < 6 h and ≥ 9 h and 24-h sleep duration ≥ 10 h were linked to increased odds of stroke in men. The ORs (95%CI) were 1.34 (1.06-1.69) in nocturnal sleep duration < 6 h, 1.30 (1.06-1.59) in nocturnal sleep duration ≥ 9 h, and 1.40 (1.15-1.71) in 24-h sleep duration ≥ 10 h in men. In addition, long naps and prolonged nocturnal sleep duration have a joint effect on stroke in the fully adjusted model., Conclusion: The napping duration and nocturnal sleep duration have independently and jointly effects on stroke in rural populations. More research is required to explore the underlying mechanisms for this relationship., Clinical Trial Registration: The Henan Rural Cohort Study has been registered on the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699) ( http://www.chictr.org.cn/showproj.aspx?proj=11375 )., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

There are increasing numbers of studies investigating the potential link between microRNAs (miRNAs) and type 2 diabetes mellitus (T2DM) risk. Based on the prior evidence and the differentially expressed candidate plasma exosome miRNAs in our established discovery study, the current meta-analysis studied miR-126 and miR-122 specifically. The purpose of the present study was to systematically and quantitatively evaluate the relationship of miR-126 and miR-22 expression level with T2DM risk as well as related glucose metabolism parameters. Moreover, the present study was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline (PRISMA 2020 statement). PubMed, Embase, Web of Science, Cochrane and Chinese National Knowledge Infrastructure electronic databases were used to identify eligible original studies prior to May 3, 2022. The random-effects models were employed to explore the overall effect estimates [odds ratio (OR) and 95% confidence interval (CI), or correlation coefficient (r, 95% CI)]. The subgroup analyses were conducted to examine the potential sources of heterogeneity. The potential publication bias was assessed by the Begg's funnel plot and Egger's tests. A total of 46 articles were included in the present meta-analysis. The results revealed that higher exposure level of miR-126 was related to lower T2DM risk in 5 analytical epidemiological studies [OR=0.73, 95% CI: (0.55, 0.96)], lower fasting blood glucose (FBG) [N=22, r=-0.26, 95% CI: (-0.42, -0.10)], and lower homeostasis model assessment of insulin resistance (HOMA-IR) index [N=9, r=-0.28, 95% CI: (-0.52, -0.05)]. Besides, positive correlations were observed between miR-122 expression and FBG [N=10, r=0.34, 95% CI: (0.20, 0.48)], as well as HOMA-IR index [N=9, r=0.40, 95% CI: (0.16, 0.64)]. The relationship of miR-126 and miR-122 expression with T2DM risk and these glucose metabolism parameters may be influenced by study types, sample size, different source and mean age of participants. In conclusion, in the general healthy population, higher miR-126 expression was related to lower T2DM risk, FBG level and HOMA-IR index; higher miR-122 expression was closely correlated with higher FBG level and HOMA-IR index. These findings have notable clinical and public health implications for screening and control glucose metabolic disorders, insulin resistance and T2DM development., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2020, Spandidos Publications.)

Objective: It is not clear whether ideal cardiovascular health (ICH) metrics have an impact on the association between age at menarche and type 2 diabetes (T2DM) in rural postmenopausal Chinese women. Methods: In all, 15,450 postmenopausal women were enrolled from the Henan Rural Cohort study. Logistic regression models and interaction plots were used to analyze associations between age at menarche, ICH metrics and T2DM and interactive effects. Results: Age at menarche was inversely associated with risk of T2DM, with adjusted OR of 1.224, 1.116, 1.00 and 0.971, 0.850 for those with age at menarche ≤13, 14, 15-16 (reference), 17, and ≥18 years, respectively, and each year of delay in menarche age correlated with a 5.1% lower risk of T2DM. Negative interaction effects of age at menarche and number of ICH metrics on the risk of T2DM was observed. Conclusion: Meeting more ICH metrics might attenuate the association between early menstrual age and increased risk of T2DM, implying that meeting a higher number of ICH metrics may be an effective way to prevent T2DM for women of early menarche age., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wu, Bao, Liu, Liao, Kang, Sang, Abdulai, Zhai, Wang and Li.)

The established evidence of cooking fuel use and socioeconomic status related to anemia is limited in low- and middle-income countries. The current study aims to examine the independent and combined effects of cooking fuel use and socioeconomic status on anemia risk as well as anemia-related parameters in rural China. A total of 21,050 participants were included from the baseline of the Henan Rural Cohort. Anemia was determined according to the World Health Organization criteria. Data on cooking fuel use (electricity, gas and solid fuel) and socioeconomic status (education and income levels) were collected using a standardized questionnaire by face-to-face interview. Logistic and linear regression models were applied to evaluate the effects of cooking fuel use or socioeconomic indicators on anemia risk, hemoglobin (HGB), red blood count (RBC), and hematocrit (HCT) levels. Using gas or solid fuel for cooking was positively associated with prevalent anemia risk and negatively related to HGB, RBC, and HCT levels compared to using electricity. Significant independent associations were also found between socioeconomic status (education and income levels) and prevalent anemia risk as well as these anemia-related parameters. In general, with decreased socioeconomic status, associations of using gas or solid fuel for cooking with advanced anemia risk as well as lower anemia-related parameters were increased. Furthermore, participants using gas or solid fuel for cooking and with lower education or income level were related to increased high anemia risk as well as low HGB, RBC and HCT levels, compared to those using electricity for cooking and with high education or income level (P <0.05 for all). The finding suggested that lower socioeconomic status strengthens the adverse effect of cooking fuel use on the higher anemia risk and lower HGB, RBC, and HCT levels in rural China., Competing Interests: Declaration of competing interest All authors have read and approved this version of the article, and declared that they had no competing or financial interests to disclosure., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: The combined effect of sleep quality and night sleep duration on health-related quality of life (HRQoL) remains unclear, especially in resource-limited countries and areas. This study aimed to explore the independent and combined effects of sleep quality and night sleep duration on HRQoL., Methods: A total of 21,926 eligible participants from the Henan rural cohort study were selected. The Pittsburgh Sleep Quality Index was utilized to evaluate sleep quality and night sleep duration. The Tobit regression model, generalized linear model (GLM), and logistic regression model were performed to assess the associations of sleep quality and night sleep duration with HRQoL. The restricted cubic spline was applied to identify the dose-response relationships of sleep quality and night sleep duration with HRQoL., Results: After multivariable adjustment, the Tobit regression and GLM indicated that the regression coefficients [95% confidence interval (CI)] for poor sleep quality were - 0.124 (- 0.133, - 0.114) and - 6.25 (- 6.71, - 5.78) on utility index and VAS score, respectively. Compared with the reference group (7 h-), participants with short sleep duration (< 6 h) or long sleep duration (≥10 h) reported a lower HRQoL. A U-shape relationship between night sleep duration and HRQoL was observed, along with a J-shape relationship between sleep quality and HRQoL (P for non-linear < 0.001). Furthermore, individuals with longer night sleep duration (≥10 h) and poorer sleep quality were strongly associated with lower HRQoL (utility index [odds ratio (OR) (95% CI)]: 6.626 (3.548, 8.920), VAS score [OR (95% CI)]: 2.962 (1.916, 4.578))., Conclusion: Poor sleep quality and extreme night sleep duration were independently and combinedly associated with low HRQoL, suggesting that maintaining good sleep quality and appropriate night sleep duration was important., Clinical Trial Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 06 July, 2015. http://www.chictr.org.cn/showproj.aspx?proj=11375 ., (© 2022. The Author(s).)

Background: Over the past few decades, more studies have suggested that the age at menarche (AAM) has continued to decline. However, the AAM for women in resource-constrained areas is not clear. Moreover, the association between the Chinese famine and AAM is still unclear in rural regions., Aim: The study aimed to investigate the secular trends of AAM for women born between 1935 and 2000 and to further explore the effect of famine on AAM in rural China., Subjects and Methods: The study included 23,444 women participants from the baseline study of the Henan Rural Cohort study. Changing AAM over time was analysed using linear regressions. Multinomial logistic regression was conducted to analyse the association between famine exposure and AAM subgroups., Results: The age-standardised mean AAM was 14.74 years. The average AAM declined from 16.98 years for those born in 1935 to 13.87 years for those born in 2000, a decline of 0.077 years per 1 year and 0.729 years per decade. Compared to the reference group, women exposed to famine during foetal, early childhood, middle childhood, and late childhood were 1.376 (95% CI = 1.071-1.769), 1.848 (95% CI = 1.512-2.259), 2.084 (95% CI = 1.725-2.518), and 2.146 (95% CI = 1.788-2.576) times more likely to be ≥18 years AAM than women unexposed to famine, respectively., Conclusion: AAM showed a decreasing trend in rural China. Furthermore, both foetal and childhood famine exposure, especially in late childhood, were positively associated with increased AAM compared to unexposed famine.

Objective: The purposes of the present study were to explore independent and interactive associations between night sleep duration, night sleep quality and coronary heart disease (CHD) based on a rural population in China., Methods: A total of 27,935 participants (11,177 men and 16,758 women) were investigated from the Henan Rural Cohort. Information about sleep was assessed by using the Pittsburgh Sleep Quality Index (PSQI). Restricted cubic splines and logistic regression were used to estimate the relationship between night sleep duration and quality with CHD., Result: Among the 27,935 participants, 1506 participants with CHD were identified. Compared with participants with scores lower than 3, the odds ratios (ORs) and 95% confidence intervals (95% CIs) of participants with score of 3-5, 6-8, ≥9 were respectively 1.42 (1.24-1.63), 1.99 (1.70-2.33), and 2.56 (2.13-3.08) with full adjustment of covariates. Compared with night sleep duration of 7 h, men and women who slept less than 5 h were 1.55 (1.11-2.17), 1.12 (0.59-2.12) and 1.80 (1.20-2.68), after being adjusted ORs (95% CIs) of the total. Moreover, the ORs and 95% CIs of CHD increased with the shortening of sleep duration at PSQI score above the highlighted levels., Conclusion: Poor sleep quality and short night sleep duration were all associated with CHD in Chinese rural areas. Moreover, the association was more obvious in women. In addition, the strongest prevalence of CHD was found in short sleepers with poor sleep quality., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: The study aimed to characterize the prevalence of alcohol consumption and further investigate the relationship between alcohol consumption and type 2 diabetes mellitus (T2DM)., Methods: We studied 39,259 participants aged 18 to 79 years of the Henan Rural Cohort study. The associations between alcohol consumption and T2DM were examined using the logistic regression models and restricted cubic spline., Results: For men, alcohol abstinence was associated with an increased risk of T2DM (1.491(1.265, 1.758)), whereas current drinkers were not associated with T2DM (1.03(0.91, 1.15)). Further analysis of alcohol drinkers revealed that only high-risk drinkers of WHO drinking risk levels increased the risk of T2DM (1.289(1.061,1.566)) compared to never drinkers. The risk of T2DM increased as the age of starting to consume alcohol decreased and as the number of years of consuming alcohol and the alcohol intake increased only in men. We further found that the risk of T2DM decreased as the number of years of abstinence increases and no association between alcohol abstinence and T2DM was found after more than 10 years of abstinence among men., Conclusions: Our results suggested that reducing the amount of alcohol consumed and adhering to abstinence from alcohol consumption are beneficial in reducing the risk of T2DM., Trial Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06. http://www.chictr.org.cn/showproj.aspx?proj=11375., (© 2021. The Author(s).)

Background: Previous reports about health-related quality of life (HRQoL) of type 2 diabetes mellitus (T2DM) concentrated on general patients rather than patients in rural areas with poor infrastructure and limited resources. Thus, the aims of this study were to evaluate the HRQoL of diabetics in the countryside and explore its influencing factors., Methods: A total of 23 053 participants aged from 18 to 79 years were drawn from the Henan Rural Cohort Study for this cross-sectional study. The HRQoL of participants were assessed by utility index and VAS-score of European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L) instrument. Binary logistic regression, generalized linear and tobit regression models were used to estimate the potential influencing factors on HRQoL., Results: This study (23 053 participants) included 2231 T2DM patients with a crude prevalence of 9.68%. The utility index and VAS-score in health group were 0.96 ± 0.10 and 78.85 ± 14.53, while in T2DM group were 0.93 ± 0.15 and 74.09 ± 16.09, respectively. In total, most diabetics reported problem about pain/discomfort dimension. Being old, poverty, low physical activity, and with comorbidities was negatively related to HRQoL of diabetics, while high educational level was positively related to HRQoL., Conclusion: HRQoL of rural T2DM patients depended on several sociodemographic factors. More attention should be paid to diabetics with poor socioeconomic status in rural areas., Clinical Trial Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699) http://www.chictr.org.cn/showproj.aspx?proj=11375., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)

Background: The study aimed to investigate the independent and combined effects of midpoint of sleep and night sleep duration on type 2 diabetes mellitus (T2DM) in areas with limited resources., Methods: A total of 37,276 participants (14,456 men and 22,820 women) were derived from the Henan Rural Cohort Study. Sleep information was assessed based on the Pittsburgh Sleep Quality Index. Logistic regression models and restricted cubic splines were used to estimate the relationship of the midpoint of sleep and night sleep duration with T2DM., Results: Of the 37,276 included participants, 3580 subjects suffered from T2DM. The mean midpoint of sleep among the Early, Intermediate and Late groups were 1:05 AM ±23 min, 1:56 AM ±14 min, and 2:57 AM ±34 min, respectively. Compared to the Intermediate group, adjusted odds ratios (ORs) and 95% confidence interval (CI) of T2DM were 1.13 (1.04-1.22) and 1.14 (1.03-1.26) in the Early group and the Late group. Adjusted OR (95% CI) for T2DM compared with the reference (7- h) was 1.28 (1.08-1.51) for longer (≥ 10 h) night sleep duration. The combination of late midpoint of sleep and night sleep duration (≥ 9 h) increased 38% (95% CI 10-74%) prevalence of T2DM. These associations were more obvious in women than men., Conclusions: Late and early midpoint of sleep and long night sleep duration were all associated with higher prevalence of T2DM. Meanwhile, midpoint of sleep and night sleep duration might have combined effects on the prevalence of T2DM, which provided potential health implications for T2DM prevention, especially in rural women., Trial Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699 ). Date of registration: 2015-07-06.

Objectives: The study aimed to explore the association between Ideal cardiovascular health (ICH) and health-related quality of life (HRQoL) using the European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L) among rural population. Methods: This study included 20,683 participants aged 18-79 years from "the Henan Rural Cohort study". Generalized linear and Tobit regression models were employed to explore the associations of ICH with EQ-5D-5L utility scores and visual analogue scale (VAS) scores, respectively. Results: The mean EQ-5D-5L utility scores and VAS scores were 0.962 ± 0.095 and 79.52 ± 14.02, respectively. Comparing with poor CVH participants (EQ-5D-5L utility scores and VAS scores: 0.954 ± 0.111 and 78.44 ± 14.29), people with intermediate and ideal CVH had higher EQ-5D-5L utility scores (0.969 ± 0.079 and 0.959 ± 0.099) and VAS scores (80.43 ± 13.65 and 79.28 ± 14.14). ICH scores were positively correlated with EQ-5D-5L utility scores (0.007 (0.004, 0.009)) and VAS scores (0.295 (0.143, 0.446)), respectively. Conclusions: Higher ICH scores is positive associated with better HRQoL in rural population, which suggests that improvement of cardiovascular health may help to enhance HRQoL among rural population., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Wu, Liu, Liao, Kang, Sang, Abdulai, Niu, He, Zhai, Pan, Wang and Li.)

Introduction: We aimed to explore the association between night sleep duration and ideal cardiovascular health (ICH) among Chinese rural population. Methods: In all, 35,094 participants were included from the Henan Rural Cohort study. Information on sleep was collected using the Pittsburgh Sleep Quality Index. The ICH scores were evaluated. The associations between night sleep duration and ICH were examined using both linear regression and logistic regression models. Results: The mean night sleep duration for all participants was 7.75 ± 1.28 h. Compared with those with night sleep duration of 7 to <9 h by using linear regression model, a significant decrease in ICH scores was observed for participants with shorter [-0.077 (-0.131, -0.024)] and longer [-0.079 (-0.121, -0.036)] night sleep duration. Compared with 7 to <9 h, longer sleep duration [0.919 (0.851, 0.992)] were associated with decreased odds of ideal CVH. Conclusions: Shorter and longer night sleep duration are negatively associated with ICH among rural population. This suggests that it may be beneficial to include night sleep duration assessment in cardiovascular risk screening., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Wu, Liu, Liao, Kang, Sang, Abdulai, Zhai, Wang, Wang and Li.)

Background: Long-term exposure to ambient air pollution and physical activity are linked to metabolic syndrome (MetS). However, the joint effect of physical activity and ambient air pollution on MetS remains largely unknown in rural Chinese adult population., Methods: In this study, 39 089 individuals were included from the Henan Rural Cohort study that recruited 39 259 individuals at the baseline. Participants' exposure to air pollutants (including particulate matter with an aerodynamic diameter ≤ 1.0 µm (PM 1 ), ≤2.5 µm (PM 2.5 ), or ≤ 10 µm (PM 10 ) and nitrogen dioxide (NO 2 )) were evaluated by using a spatiotemporal model based on satellites data. Individuals were defined as MetS according to the recommendation of the Joint Interim Societies. Physical activity-metabolic equivalent (MET) was calculated based on the formula of MET coefficient of activity × duration (hour per time) × frequency (times per week). Generalized linear models were used to analyze the individual air pollutant or physical activity and their interaction on MetS. Interaction effects of individual air pollutant and physical activity on MetS were assessed by using Interaction plots which exhibited the estimated effect of physical activity on MetS as a function of individual air pollutant., Results: The prevalence of MetS was 30.8%. The adjusted odd ratio of MetS with a per 5 µg/m 3 increase in PM 1 , PM 2.5 , PM 10 , NO 2 or a 10 MET (hour/day) of physical activity increment was 1.251(1.199, 1.306), 1.424(1.360, 1.491), 1.228(1.203, 1.254), 1.408(1.363, 1.455) or 0.814(0.796, 0.833). The protective effect of physical activity on MetS was decreased with accompanying air pollutant concentrations increased., Conclusions: The results indicated that long-term exposure to ambient air pollutants related to increased risk of MetS and physical activity attenuated the effects of ambient air pollutants on increased risk for MetS., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The purpose of this study is to update the prevalence of metabolic syndrome (MetS) and explore to identify the susceptible populations. A total of 38208 subjects aged 18 to 79 years were obtained from the Henan Rural Cohort Study (n = 39259). Five criteria (ATP β, IDF, JIS, CDS, EGIR) were used to estimate the prevalence of MetS. Multivariate logistic regression analysis was used to assess odds ratios (ORs) and 95% confidence interval (CI) of potential risk factors with MetS. The age-standardized prevalence of MetS were 27.87%, 24.63%, 27.40%, 18.00% and 8.91% according to the standard of ATP β, IDF, JIS, CDS, and EGIR, respectively. After adjusted for the potential confounding factors, aging, females, physical activity and the state of drinking were independent risk factors of MetS. MetS is positively associated with stroke and coronary heart disease in all five criteria (P < 0.01). The current data identify a high prevalence of MetS among Chinese rural adults. Especially for aged females with unhealthy lifestyle had a higher risk for MetS.