Derived dataset and analysis code for rural older adults (KNHANES 2023)

Abstract Background. Rural older adults experience elevated cardiometabolic risks, yet modifiable determinants of metabolic syndrome (MetS) in this population remain undercharacterized. Methods. We conducted a cross-sectional, survey-weighted analysis of rural adults aged ≥65 years from the 2023 Korea National Health and Nutrition Examination Survey (unweighted n=467). The complex sampling design (strata, clusters, weights) was incorporated. MetS followed NCEP ATP III criteria adapted for Asian populations (≥3 of 5 components). Design-based tests summarized group differences, and complex-sample logistic regression estimated adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Results. Participants with MetS showed more adverse profiles (e.g., higher triglycerides and fasting glucose, lower HDL-C), whereas LDL-C did not differ materially between groups. Vitamin D status was less favorable with MetS (mean 25(OH)D 25.20 vs 28.33 ng/mL; deficiency <20 ng/mL 33.6% vs 19.8%). MetS_Ro_Tables0927 In fully adjusted models, BMI ≥25 kg/m² (aOR 9.08; 95% CI 6.01–13.71), HbA1c ≥7.0% (aOR 4.42; 1.75–11.16), and vitamin D deficiency <20 ng/mL (aOR 2.32; 1.23–4.35) were associated with higher odds of MetS, whereas meeting the World Health Organization physical-activity guideline was inversely associated (aOR 0.50; 0.26–0.96); other covariates (sex, age, education, income, smoking, alcohol use, sleep duration, LDL-C ≥130 mg/dL) were not independently related. Model fit under the survey design was acceptable (modified F(12,10)=9.954; p<.001). Conclusions. Among rural Korean older adults, adiposity, suboptimal glycemic control, and vitamin D deficiency were independently associated with MetS, whereas meeting physical-activity recommendations was protective. These findings indicate pragmatic, community-deliverable levers—weight management, glycemic optimization, attention to vitamin D status, and promotion of physical activity—for MetS prevention in underserved rural settings.