BACKGROUND: Due to the recent increase of metabolic syndrome (MetS) in the Korean population, this study was performed to investigate the prevalence of MetS among Republic of Korea (ROK) Air Force military aviators and its relationship with clinical markers.METHODS: A cross-sectional study was performed among 911 aviators who filled out the lifestyle questionnaire and underwent medical examinations at the ROK Air Force Aerospace Medical Center. Clinical markers of aviators with MetS were investigated and odds ratios were calculated.RESULTS: Among the 911 aviators, 90 (9.9%) were found to have MetS and the prevalence of subcomponents were: 31.7% elevated blood pressure, 25.3% elevated waist circumference, 19.0% impaired glucose tolerance, 16.6% elevated triglycerides, 7.9% reduced high density lipoprotein (HDL) cholesterol. Among aviators, a significant statistical association was found between the diagnosis of MetS with the highest quartile of uric acid, white blood cell (WBC) count, and alanine transaminase (ALT) level. Adjusted odds ratio of MetS was 8.88 (3.16 ∼24.99) if all three clinical markers were at highest quartile range.DISCUSSION: Despite the relatively low prevalence of MetS in ROK Air Force aviators, further preventive measures are required as the prevalence is expected to increase in the future. Aviators with high levels of WBC count, uric acid, and ALT should be examined for MetS. Further comprehensive cohort study is required to link the elevation of clinical markers and development of MetS.Rhee C, Kim J, Kim J-Y, Chang E, Park S, Lee W, Kang H. Clinical markers associated with metabolic syndrome among military aviators. Aerosp Med Hum Perform. 2015; 86(11):970–975.