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Background: Metabolic risk factors and abnormalities such as obesity and hypertension are rapidly rising among the Chinese population following China's tremendous economic growth and widespread westernization of lifestyle in recent decades. Limited information is available about the current burden of metabolic syndrome (MetS) in China. Methods: We analyzed data on metabolic risk factors among 22,457 adults aged = 32 years participating in the "Zhabei Health 2020" survey (2009-2010), a cross-sectional study of a representative sample of community residents in Zhabei District. We defined MetS using Chinese-specific cut-off points for central obesity according to consensus criteria recently endorsed by several international and national organizations in defining MetS in different populations worldwide. We used a multiple logistic regression model to assess the associations of potential risk factors with MetS. Results: The unadjusted prevalence of the MetS was 35.1% for men and 32.5% for women according to the consensus criteria for Chinese. The prevalence increased progressively from 12.1% among participants aged 32-45 years to 45.4% among those aged = 75 years. Age, smoking, family history of diabetes, and education are significantly associated with risk of MetS. Conclusions: The MetS is highly prevalent and has reached epidemic proportion in Chinese urban adult community residents. [ABSTRACT FROM AUTHOR]