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Yusufu I, Nagu T, Ottaru TA, Sando MM, Kaaya S, Mbugi E, Hirschhorn LR, Hawkins C. The prevalence of metabolic syndrome and associated factors among adults on antiretroviral therapy in Dar es Salaam, Tanzania. RESEARCH SQUARE 2024:rs.3.rs-4372785. [PMID: 38798337 PMCID: PMC11118687 DOI: 10.21203/rs.3.rs-4372785/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Background Adults living with HIV (ALHIV) are at increased risk of developing metabolic syndrome (MetS). Several factors are associated with an increase in MetS in these individuals, including certain antiretroviral therapies (ART). There is limited data on the prevalence of MetS among ALHIV in sub-Saharan Africa following scale up of newer integrase inhibitor-containing ART regimens. Objective We assessed the prevalence and correlates of MetS among ALHIV patients receiving tenofovir, lamivudine, and dolutegravir (TLD) in Tanzania. Methods We conducted a retrospective cross-sectional analysis of ALHIV aged ≥18 enrolled in a cardiovascular health study at six HIV Care and Treatment Clinics from 11/2020-1/2021 in Dar es Salaam, Tanzania. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). Descriptive statistics were used to summarize the results, and logistic regression was used to assess demographic, behavioral, and HIV-related risk factors associated with MetS. Covariates with a p-value <0.2 at the univariate level were included in the multivariate model. Results Three hundred and eighty nine participants were included in the analysis. The mean age (SD) was 43 years (±11) years, and 286 (73.5%) were female. The prevalence of MetS in this population was 21%. In univariate analysis, MetS components that were significantly higher among women vs. men included abdominal obesity (27.3% vs. 4.9%), reduced HDL (77.9% vs. 53.4%), and elevated glucose (18.5% vs. 14.6%), all p< 0.05. Age≥ 50 yrs [AOR 3.25; (95% CI 1.80-5.84), p < 0.01] and BMI [AOR 0.16; (95% CI 0.09-0.30), P ≤0.01] were both associated with an increased odds of MetS in multivariate analyses. Conclusion MetS. is prevalent among Tanzanian ALHIV on TLD. Routine screening for MetS and healthy lifestyle promotion, particularly among women and those aging, should be a priority to prevent against cardiovascular disease. Further studies are needed to monitor the long-term impact of these newer ART regimens on MetS and CVD.
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Affiliation(s)
| | - Tumaini Nagu
- Muhimbili University of Health and Allied Sciences
| | | | | | - Sylvia Kaaya
- Muhimbili University of Health and Allied Sciences
| | - Erasto Mbugi
- Muhimbili University of Health and Allied Sciences
| | - Lisa R Hirschhorn
- Robert J. Havey, MD Institute for Global Health, Feinberg School of Medicine, Northwestern University
| | - Claudia Hawkins
- Robert J. Havey, MD Institute for Global Health, Feinberg School of Medicine, Northwestern University
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Enriquez R, Homsi M, Ssekubugu R, Nabukalu D, Zeebari Z, Marrone G, Gigante B, Chang LW, Reynolds SJ, Nalugoda F, Ekström AM, Hagström H, Nordenstedt H. Prevalence and risk factors of metabolic dysfunction-associated steatotic liver disease in south Central Uganda: A cross-sectional survey. Aliment Pharmacol Ther 2024; 59:1111-1121. [PMID: 38459720 DOI: 10.1111/apt.17931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/16/2024] [Accepted: 02/16/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Despite numerous risk factors and serious consequences, little is known about metabolic dysfunction-associated steatotic liver disease (MASLD) at population level in Africa. AIM The aim of the study was to estimate the prevalence and risk factors of MASLD in people living with and without HIV in Uganda. METHODS We collected data from 37 communities in South Central Uganda between May 2016 and May 2018. We estimated MASLD prevalence using the fatty liver index and advanced liver fibrosis using the dynamic aspartate-to-alanine aminotransferase ratio. We collected additional data on sociodemographics, HIV and cardiovascular disease (CVD) risk factors. We used multivariable logistic regression to determine the association between HIV, CVD risk factors and MASLD. RESULTS We included 759 people with HIV and 704 HIV-negative participants aged 35-49. MASLD prevalence was 14% in women and 8% in men; advanced liver fibrosis prevalence was estimated to be <1%. MASLD prevalence was more common in women (15% vs. 13%) and men (9% vs. 6%) with HIV. Being female (odds ratio [OR] = 2.1; 95% confidence interval [CI] = 1.4-3.3) was associated with a higher odds of MASLD after adjustment for confounders; HIV infection was borderline associated with MASLD (OR = 1.4; 95% CI: 1.0-2.0). CONCLUSIONS In a relatively young cohort in Uganda, 14% of women and 8% of men had MASLD. There was an indication of an association between HIV and MASLD in multivariable analysis. These data are the first to describe the population-level burden of MASLD in sub-Saharan Africa using data from a population-based cohort.
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Affiliation(s)
- Rocio Enriquez
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Mahmoud Homsi
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Zangin Zeebari
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Jönköping International Business School, Jönköping University, Jönköping, Sweden
| | - Gaetano Marrone
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Bruna Gigante
- Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Larry W Chang
- Rakai Health Sciences Program, Kalisizo, Uganda
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Steven J Reynolds
- Rakai Health Sciences Program, Kalisizo, Uganda
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Laboratory of Immunoregulation, Division of Intramural Research, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Anna Mia Ekström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, Venhälsan, Södersjukhuset, Stockholm, Sweden
| | - Hannes Hagström
- Unit of Hepatology, Division of Upper Gastrointestinal Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Helena Nordenstedt
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Internal Medicine and Infectious Diseases, Danderyd University Hospital, Stockholm, Sweden
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Pan Y, Han X, Tu Y, Zhang P, Yu H, Bao Y. Nomogram for Predicting Remission of Metabolic Syndrome 1 Year after Sleeve Gastrectomy Surgery in Chinese Patients with Obesity. Obes Surg 2024; 34:1590-1599. [PMID: 38478194 DOI: 10.1007/s11695-024-07156-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE Sleeve gastrectomy (SG) is a widely used and effective treatment for patients with obesity and comorbid metabolic abnormalities. No specialized tool is available to predict metabolic syndrome (MS) remission after SG. We presented a nomogram that evaluated the probability of MS remission in obese patients 1 year after SG. MATERIALS AND METHODS Patients with preoperative MS who underwent SG were enrolled in this retrospective study. They were divided into a training set and a validation set. Multivariate logistic regression analysis was performed to identify independent predictors of MS remission, and these predictors were included in the nomogram. Receiver operating characteristic curve was used to evaluate discrimination. Calibration was performed with the Hosmer-Lemeshow goodness-of-fit test. The net benefits of the nomogram were evaluated using decision curve analysis (DCA). RESULTS Three hundred and eighteen patients with a median age of 34.0 years were analyzed. A training set and a validation set with 159 individuals each were established. A combination of age, preoperative high-density lipoprotein cholesterol, elevated triglycerides and glycated hemoglobin level independently and accurately predicted MS remission. The nomogram included these factors. The discriminative ability was moderate in training and validation sets (Area under curve 0.800 and 0.727, respectively). The Hosmer-Lemeshow X2 value of the nomogram was 8.477 (P = 0.388) for the training set and 5.361 (P = 0.718) for the validation set, indicating good calibration. DCA showed the nomogram had clinical benefits in both datasets. CONCLUSION Our nomogram could accurately predict MS remission in Chinese patients with obesity 1 year after SG.
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Affiliation(s)
- Yunhui Pan
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai, 200233, China
| | - Xiaodong Han
- Department of General Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Yinfang Tu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai, 200233, China
| | - Pin Zhang
- Department of General Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Haoyong Yu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai, 200233, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai, 200233, China.
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Mengome MFA, Kono HN, Bivigou EA, M’bondoukwe NP, Ngomo JMN, Ditombi BM, Ngondza BP, Bisseye C, Mawili-Mboumba DP, Bouyou Akotet MK. Prevalence of cardiometabolic risk factors according to urbanization level, gender and age, in apparently healthy adults living in Gabon, Central Africa. PLoS One 2024; 19:e0285907. [PMID: 38578783 PMCID: PMC10997135 DOI: 10.1371/journal.pone.0285907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 03/14/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND The prevalence of cardiometabolic risk factors (CMRFs) is increasing in sub-Saharan Africa and represents a serious public health issue. Accurate data are required to implement adapted prevention programs and healthcare strategies. Thus, the aim of this study was to estimate the prevalence rates of CMRFs according to the level of urbanization, age and gender in Gabon. METHODS A cross-sectional study was conducted in northern (Bitam), western coast (Libreville, Melen) and southeast (Koulamoutou) areas of Gabon using the World Health Organization's (WHO) stepwise approach for the surveillance of chronic disease risk factors. Participants over 18 years of age, without known underlying disease, living in rural and urban areas of Gabon were included. Sociodemographic, biological, and behavioral data were collected. Univariate and multivariate analysis were used to identify the CMRFs. RESULTS Of the 978 participants, 499 lived in urban and 479 in rural areas. Their median age was 38[28-50] years. Tobacco (26.1% vs 6.2%; p < 0.01) and excessive alcohol consumption (19.4% vs 9.6%; p < 0.01) predominated in rural than in urban areas, respectively. Urban dwellers had more often insufficient physical activity than rural people (29.5% vs 16.3%; p < 0.01). In total, 79.9% of participants aged under 54 years had a high blood pressure;10.6% of the younger participants had pre-hypertension. Metabolic syndrome was more frequent in women (21.7%) than in men (10.0%) (p < 0.01); 6.4% of men and 2.5% of women had a high Framingham score (p = 0.03). Finally, 54.0% of the participants had three or four CMRFs. The multivariate analysis showed that men were more likely to be smokers and to be at risk of pre-hypertension or high blood pressure (p < 0.01). Women were more likely to be obese or to have a metabolic syndrome (p < 0.01). Living in urban areas was also a risk factor for hypertension, diabetes, metabolic syndrome and high LDL cholesterol level. CONCLUSION The prevalence of CMRFs was high in the study population. Disparities were observed according to urban and rural areas, gender and age. National prevention and healthcare strategies for cardiometabolic diseases in Gabon should consider these observed differences.
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Affiliation(s)
- Mérédith Flore Ada Mengome
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Héléna Noéline Kono
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Elsa Ayo Bivigou
- Faculté de Médecine, Département de Médecine, Université des Sciences de la Santé, Libreville, Gabon
| | - Noé Patrick M’bondoukwe
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
| | - Jacques-Mari Ndong Ngomo
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
| | - Bridy Moutombi Ditombi
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
| | - Bedrich Pongui Ngondza
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
| | - Cyrille Bisseye
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
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Olowoyo P, Maffia P, Guzik TJ, Owolabi M. Understanding and controlling the increasing burden of cardiovascular diseases in Africa. Cardiovasc Res 2024; 120:e9-e13. [PMID: 38442189 PMCID: PMC10981519 DOI: 10.1093/cvr/cvad173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/02/2023] [Accepted: 10/19/2023] [Indexed: 03/07/2024] Open
Affiliation(s)
- Paul Olowoyo
- Department of Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria
- College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Pasquale Maffia
- School of Infection & Immunity, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- Africa-Europe Cluster of Research Excellence (CoRE) in Non-Communicable Diseases & Multimorbidity, African Research Universities Alliance ARUA & The Guild, University of Glasgow, Scotland, UK
- Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
- School of Cardiovascular & Metabolic Health, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Tomasz J Guzik
- Africa-Europe Cluster of Research Excellence (CoRE) in Non-Communicable Diseases & Multimorbidity, African Research Universities Alliance ARUA & The Guild, University of Glasgow, Scotland, UK
- Centre for Cardiovascular Sciences, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK
- Department of Internal and Agricultural Medicine and Omicron Medical Genomics Laboratory, Jagiellonian University Collegium Medicum, Krakow, Poland
| | - Mayowa Owolabi
- Africa-Europe Cluster of Research Excellence (CoRE) in Non-Communicable Diseases & Multimorbidity, African Research Universities Alliance ARUA & The Guild, University of Glasgow, Scotland, UK
- Centre for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Nigeria
- Lebanese American University of Beirut, Beirut, Lebanon
- Blossom Specialist Medical Center, Ibadan, Nigeria
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Russell JBW, Koroma TR, Sesay S, Samura SK, Lakoh S, Bockarie A, Abiri OA, Conteh V, Conteh S, Smith M, Mahdi OZ, Lisk DR. Prevalence and correlates of metabolic syndrome among adults in freetown, Sierra Leone: A comparative analysis of NCEP ATP III, IDF and harmonized ATP III criteria. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2024; 20:200236. [PMID: 38299125 PMCID: PMC10827589 DOI: 10.1016/j.ijcrp.2024.200236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/25/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024]
Abstract
Background Metabolic syndrome (MetS) is a global health concern, especially for low and middle-income countries with limited resources and information. The study's objective was to assess the prevalence of MetS in Freetown, Sierra Leone, using the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), International Diabetes Federation (IDF) and Harmonize ATP III. Additionally, we aimed to establish the concordance between these three different criteria used. Methods This community-based health screening survey was conducted from October 2019 to October 2022. A multistage stratified random design was used to select adults aged 20 years and above. Mean, interquartile range (IQR), and logistic regression were used for statistical analysis. The kappa coefficient statistics resolved the agreement between these defined criteria. Results The prevalence for NCEP ATP III, Harmonize ATP III and IDF criteria was 11.8 % (95 % CI: 9.0-15.15), 14.3 % (95 % CI: 11.3-18.0), and 8.5 % (95 % CI: 6.2-11.2), respectively for the 2394 selected adults. The kappa coefficient (κ) agreement between the MetS is: Harmonized ATP III and IDF criteria = [(208 (60.8 %); (κ = 0.62)]; Harmonized ATP III and NCEP ATP III = [(201 (58.7 %); (κ = 0.71)]; while IDF and NCEP ATP III was [(132 (38.6 %); (κ = 0.52)]. In the multivariable regression analysis, waist circumference correlated with all three MetS criteria: ATP III [AOR = 0.85; C.I 95 %: (0.40-1.78), p = 0.032], Harmonized ATP III [AOR = 1.14; C.I 95 %: (0.62-2.11), p = 0.024], IDF [AOR = 1.06; C.I 95 % (0.52-2.16), p = 0.018]. Conclusion We reported a high prevalence of MetS in Freetown, Sierra Leone and identified waist circumference as a major risk factor for MetS. This underscores the crucial role of health education and effective management of MetS in Sierra Leone.
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Affiliation(s)
- James Baligeh Walter Russell
- Department of Internal Medicine, Faculty of Clinical Sciences & Dentistry, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
- Department of Internal Medicine, University of Sierra Leone Teaching Hospital Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Theresa Ruba Koroma
- Department of Internal Medicine, Faculty of Clinical Sciences & Dentistry, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
- Department of Internal Medicine, University of Sierra Leone Teaching Hospital Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Santigie Sesay
- Directorate of Non-Communicable Disease & Mental Health, Ministry of Health & Sanitation, Freetown, Sierra Leone
| | - Sallieu K. Samura
- Department of Mathematics and Statistics, Fourah Bah College, University of Sierra Leone, Sierra Leone
| | - Sulaiman Lakoh
- Department of Internal Medicine, Faculty of Clinical Sciences & Dentistry, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
- Department of Internal Medicine, University of Sierra Leone Teaching Hospital Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Ansumana Bockarie
- Department of Internal Medicine, School of Medical Sciences, University of Cape Coast, Ghana
| | - Onomeh Abiri Abiri
- Department of Pharmacology and Therapeutics, Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Victor Conteh
- Department of Internal Medicine, Faculty of Clinical Sciences & Dentistry, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
- Department of Internal Medicine, University of Sierra Leone Teaching Hospital Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Sorie Conteh
- Department of Internal Medicine, Faculty of Clinical Sciences & Dentistry, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
- Department of Internal Medicine, University of Sierra Leone Teaching Hospital Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Mohamed Smith
- Department of Internal Medicine, Faculty of Clinical Sciences & Dentistry, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
- Department of Internal Medicine, University of Sierra Leone Teaching Hospital Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Othman Z. Mahdi
- Department of Medicine, Choithrams Memorial Hospital, Freetown, Sierra Leone
| | - Durodami R. Lisk
- Department of Internal Medicine, Faculty of Clinical Sciences & Dentistry, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
- Department of Internal Medicine, University of Sierra Leone Teaching Hospital Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
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Musilanga N, Nasib H, Jackson G, Shayo F, Nhanga C, Girukwigomba S, Mwakibolwa A, Henry S, Kijusya K, Msonge E. Exploring the Prevalence and Components of Metabolic Syndrome in Sub-Saharan African Type 2 Diabetes Mellitus Patients: A Systematic Review and Meta-Analysis. J Obes 2024; 2024:1240457. [PMID: 38410415 PMCID: PMC10896656 DOI: 10.1155/2024/1240457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 02/28/2024] Open
Abstract
Background Type 2 diabetes mellitus and metabolic syndrome represent two closely intertwined public health challenges that have reached alarming epidemic proportions in low- and middle-income countries, particularly in sub-Saharan Africa. Therefore, the current study aimed to determine the weighted pooled prevalence of metabolic syndrome and its components among individuals with type 2 diabetes mellitus in sub-Saharan Africa as defined by the 2004 National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP III 2004) and/or the International Diabetes Federation (IDF) criteria. Methods A systematic search was conducted to retrieve studies published in the English language on the prevalence of metabolic syndrome among type 2 diabetic individuals in sub-Saharan Africa. Searches were carried out in PubMed, Embase, Scopus, Google Scholar, African Index Medicus, and African Journal Online from their inception until July 31, 2023. A random-effects model was employed to estimate the weighted pooled prevalence of metabolic syndrome in sub-Saharan Africa. Evidence of between-study variance attributed to heterogeneity was assessed using Cochran's Q statistic and the I2 statistic. The Joanna Briggs Institute quality appraisal criteria were used to evaluate the methodological quality of the included studies. The summary estimates were presented with forest plots and tables. Publication bias was checked with the funnel plot and Egger's regression test. Results Overall, 1421 articles were identified and evaluated using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, and 30 studies that met the inclusion criteria were included in the final analysis. The weighted pooled prevalence of metabolic syndrome among individuals with type 2 diabetes mellitus in sub-Saharan Africa was 63.1% (95% CI: 57.9-68.1) when using the NCEP-ATP III 2004 criteria and 60.8% (95% CI: 50.7-70.0) when using the IDF criteria. Subgroup analysis, using NCEP-ATP III 2004 and IDF criteria, revealed higher weighted pooled prevalence among females: 73.5% (95% CI: 67.4-79.5), 71.6% (95% CI: 60.2-82.9), compared to males: 50.5% (95% CI: 43.8-57.2), 44.5% (95% CI: 34.2-54.8), respectively. Central obesity was the most prevalent component of metabolic syndrome, with a pooled prevalence of 55.9% and 61.6% using NCEP-ATP III 2004 and IDF criteria, respectively. There was no statistical evidence of publication bias in both the NCEP-ATP III 2004 and IDF pooled estimates. Conclusions The findings underscore the alarming prevalence of metabolic syndrome among individuals with type 2 diabetes mellitus in sub-Saharan Africa. Therefore, it is essential to promote lifestyle modifications, such as regular exercise and balanced diets, prioritize routine obesity screenings, and implement early interventions and robust public health measures to mitigate the risks associated with central obesity.
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Affiliation(s)
- Nelson Musilanga
- Department of Internal Medicine, Maranatha Hospital, Mbeya, Tanzania
| | - Hussein Nasib
- Department of Internal Medicine, Maranatha Hospital, Mbeya, Tanzania
| | - Given Jackson
- Department of Internal Medicine, Maranatha Hospital, Mbeya, Tanzania
| | - Frank Shayo
- Department of Internal Medicine, Maranatha Hospital, Mbeya, Tanzania
| | - Clarkson Nhanga
- Department of Internal Medicine, Maranatha Hospital, Mbeya, Tanzania
| | | | | | - Samson Henry
- Department of Internal Medicine, Maranatha Hospital, Mbeya, Tanzania
| | - Keneth Kijusya
- Department of Internal Medicine, Maranatha Hospital, Mbeya, Tanzania
| | - Edgar Msonge
- Department of Urology, Mbeya Zonal Referral Hospital, Mbeya, Tanzania
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Nsabimana P, Sombié OO, Pauwels NS, Boynito WG, Tariku EZ, Vasanthakaalam H, De Henauw S, Abbeddou S. Association between urbanization and metabolic syndrome in low- and middle-income countries: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2024; 34:235-250. [PMID: 38182494 DOI: 10.1016/j.numecd.2023.07.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/06/2023] [Accepted: 07/31/2023] [Indexed: 01/07/2024]
Abstract
AIMS The prevalence of metabolic syndrome (MetS) is on the rise in an increasingly urbanized world. The study aimed to review the association between urbanization and MetS in low- and middle-income countries (LMICs). DATA SYNTHESIS A comprehensive search of five databases (MEDLINE, Web of Science, Scopus, EMBASE, and CENTRAL) was performed in January 2022 and updated in October 2022. Peer-reviewed studies that met the eligibility selection criteria were included. Search terms were used for the main concepts which are MetS, dietary patterns, and urbanization in LMICs. Study selection was done in two stages and in duplicate. Random effects models were used to calculate the overall pooled prevalence and main study-level characteristics. Out of 9,773 identified studies, nineteen were included in the systematic review and meta-analysis. The studies were done on 313,644 participants (149,616 urban and 164,028 rural). The pooled risk ratio (RR, 95% confidence interval) of MetS between urban and rural dwellers was RR = 1.24; 95%CI [1.15, 1.34] (I2 = 96.0%, P < 0.0001). A relatively higher prevalence of MetS among urban than rural residents has been observed, especially with the International Diabetes Federation criteria (RR = 1.54; 95%CI [1.21, 1.96]; I2 = 65.0%), and in the population in India (RR = 2.19; 95%CI = 1.24, 3.88, I2 = 85%). Overall, the role of dietary patterns in the development of MetS was inconsistent, and few studies showed a lower risk of MetS with adherence to recommended healthy dietary patterns. CONCLUSIONS There was an association between urbanization and the high prevalence of MetS. Interventions and policies to reduce the risk of MetS are needed.
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Affiliation(s)
- Phenias Nsabimana
- School of Agriculture and Food Sciences, College of Agriculture, Animal Sciences and Veterinary Medicine, University of Rwanda, P.O Box 210 Musanze, Rwanda; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, B-9000 Gent, Belgium.
| | - Olivier O Sombié
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, B-9000 Gent, Belgium; Unité Nutrition et Maladies Métaboliques, Institut de Recherche en Sciences de la Santé/ Direction Régionale de l'Ouest (IRSS-DRO), 01 P.O Box 545, Bobo Dioulasso, Burkina Faso
| | - Nele S Pauwels
- Knowledge Centre for Health, Ghent University Hospital, B-9000 Ghent, Belgium
| | - Wanzahun Godana Boynito
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, B-9000 Gent, Belgium; School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Eshetu Zerihun Tariku
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, B-9000 Gent, Belgium; School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Hilda Vasanthakaalam
- School of Agriculture and Food Sciences, College of Agriculture, Animal Sciences and Veterinary Medicine, University of Rwanda, P.O Box 210 Musanze, Rwanda
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, B-9000 Gent, Belgium
| | - Souheila Abbeddou
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, B-9000 Gent, Belgium
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9
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Alamnia TT, Sargent GM, Kelly M. Dietary patterns and associations with metabolic risk factors for non-communicable disease. Sci Rep 2023; 13:21028. [PMID: 38030642 PMCID: PMC10687098 DOI: 10.1038/s41598-023-47548-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023] Open
Abstract
Unhealthy dietary habit is a major contributor to the burden of non-communicable diseases such as cardiovascular diseases, diabetes, and hypertension, especially the increased burden in low- and middle-income countries. Evidence of the association between specific dietary patterns and health outcomes is scarce in sub-Saharan African countries. This study aimed to identify principal dietary patterns and evaluate associations with metabolic risk factors including hypertension, overweight/obesity, and abdominal obesity in Northwest Ethiopia. A community-based cross-sectional survey was conducted among adults in Bahir Dar, Northwest Ethiopia, from 10 May 2021 to 20 June 2021. Dietary intake was collected using a validated food frequency questionnaire. Anthropometric (weight, height, hip/waist circumference) and blood pressure measurements were performed using standardized tools. Principal component analysis was conducted to derive dietary patterns. Chi-square and logistic regression analyses were used to examine the association between dietary patterns and metabolic risk factors and with sociodemographic and individual risk factors. This study derives two types of dietary patterns: 'westernized' dietary pattern, which is positively correlated with consumption of meat, dairy, fast foods, alcohol, fish, sweet/sugary foods, and fruits, and 'traditional' dietary pattern, which is positively correlated with intake of cereals, vegetables, legumes, roots/tubers, coffee, and oils. The prevalence of hypertension was significantly lower in adults with higher quantiles of westernized dietary pattern (AOR = 0.28, 95% CI 0.13 to 0.60; p < 0.01; quantile three); and (AOR = 0.35, 95% CI 0.17, 0.75; p < 0.01; quantile four). Younger, married, and middle-income adults were associated with the highest quantile of the westernized pattern. Being females and having middle income associated with the highest quantile of traditional dietary patterns (p < 0.05). This study suggested two types of dietary patterns, westernized and traditional, among adults in Northwest Ethiopia and revealed a significant association with metabolic risk factors like hypertension. Identifying the main dietary patterns in the population could be informative to consider local-based dietary recommendations and interventions to reduce metabolic risk factors.
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Affiliation(s)
- Tilahun Tewabe Alamnia
- National Centre for Epidemiology and Population Health, Australian National University, 62 Mills RD, Acton ACT 2601, Canberra, Australia.
- College of Medical and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Ginny M Sargent
- National Centre for Epidemiology and Population Health, Australian National University, 62 Mills RD, Acton ACT 2601, Canberra, Australia
| | - Matthew Kelly
- National Centre for Epidemiology and Population Health, Australian National University, 62 Mills RD, Acton ACT 2601, Canberra, Australia
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10
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Ngwasiri C, Kinoré M, Samadoulougou S, Kirakoya-Samadoulougou F. Sex-specific-evaluation of metabolic syndrome prevalence in Algeria: insights from the 2016-2017 non-communicable diseases risk factors survey. Sci Rep 2023; 13:18908. [PMID: 37919315 PMCID: PMC10622436 DOI: 10.1038/s41598-023-45625-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 10/21/2023] [Indexed: 11/04/2023] Open
Abstract
Metabolic syndrome (MetS) is a core driver of cardiovascular diseases (CVD); however, to date, gender differences in MetS prevalence and its components have not been assessed in the Algerian adult general population. This study aimed to determine the gender differences in MetS prevalence and its components, in the general population of Algeria. Secondary analysis was performed on data from the Algerian 2016-2017 non-communicable disease risk factor survey. MetS was determined according to the harmonized Joint Interim Statement criteria. A Poisson regression model based on Generalised Estimating Equations was used to estimate the adjusted prevalence ratios (aPR) for the sex-specific factors associated with MetS. Overall, the prevalence of MetS was 34.0% (95% CI 32.4-35.6). MetS prevalence in women and men was 39.1% (95% CI 37.0-41.3) and 29.1% (95% CI 27.2-31.2), respectively. The most frequent triad was the clustering of abdominal obesity with low HDL-cholesterol and high blood pressure among women (8.9%; 95% CI [8.0-10.0]) and low HDL-cholesterol with high blood pressure and hyperglycaemia among men (5.2%; 95% CI [4.3-6.3]). Increasing age (aPR 3.21 [2.35-4.39] in men and aPR 3.47 [2.86-4.22] in women), cohabitation (aPR 1.14 [1.05-1.24]), women residing in urban areas (aPR 1.13 [1.01-1.26]), men with higher educational levels (aPR 1.39 [1.14-1.70]), and men with insufficient physical activity (aPR 1.16 [1.05-1.30]) were associated with higher risk of MetS. In this population-based study, one in three Algerian adults had MetS, and key components including abdominal obesity, low HDL-cholesterol, and high blood pressure, are very common, especially in women. Reinforcing interventions for weight management targeting married women living in urban areas and improving sufficient physical activity in men with higher socioeconomic status could provide maximal health gains and stem the CVD epidemic in Algeria.
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Affiliation(s)
- Calypse Ngwasiri
- Clinical Research Education Networking and Consultancy (CRENC), RFMR+QFH, Yaoundé, Centre Region, Cameroon.
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université libre de Bruxelles, Brussels, Belgium.
| | - Mikaila Kinoré
- Département de Biochimie et Microbiologie, UFR-SVT, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Sekou Samadoulougou
- Centre for Research on Planning and Development, Université Laval, Quebec, QC, G1V 0A6, Canada
| | - Fati Kirakoya-Samadoulougou
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université libre de Bruxelles, Brussels, Belgium
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11
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Silva-Ochoa AD, Velasteguí E, Falconí IB, García-Solorzano VI, Rendón-Riofrio A, Sanguña-Soliz GA, Vanden Berghe W, Orellana-Manzano A. Metabolic syndrome: Nutri-epigenetic cause or consequence? Heliyon 2023; 9:e21106. [PMID: 37954272 PMCID: PMC10637881 DOI: 10.1016/j.heliyon.2023.e21106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 09/08/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023] Open
Abstract
Metabolic syndrome is a cluster of conditions that results from the interplay of genetic and environmental factors, which increase the comorbidity risk of obesity, hyperglycemia, dyslipidemia, arterial hypertension, stroke, and cardiovascular disease. In this article, we review various high-impact studies which link epigenetics with metabolic syndrome by comparing each study population, methylation effects, and strengths and weaknesses of each research. We also discuss world statistical data on metabolic syndrome incidence in developing countries where the metabolic syndrome is common condition that has significant public health implications.
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Affiliation(s)
- Alfonso D. Silva-Ochoa
- Laboratorio para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral, ESPOL, Campus Gustavo Galindo Km. 30.5 Vía Perimetral, P.O. Box 09-01-5863, Guayaquil, Ecuador
- Licenciatura en Nutrición y Dietética, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral, ESPOL, Campus Gustavo Galindo Km. 30.5 Vía Perimetral, P.O. Box 09-01-5863, Guayaquil, Ecuador
| | - Erick Velasteguí
- Laboratorio para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral, ESPOL, Campus Gustavo Galindo Km. 30.5 Vía Perimetral, P.O. Box 09-01-5863, Guayaquil, Ecuador
- Departamento de Ciencias de Alimentos y Biotecnología, Escuela Politécnica Nacional, Quito, Ecuador
| | - Isaac B. Falconí
- Laboratorio para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral, ESPOL, Campus Gustavo Galindo Km. 30.5 Vía Perimetral, P.O. Box 09-01-5863, Guayaquil, Ecuador
| | - Valeria I. García-Solorzano
- Laboratorio para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral, ESPOL, Campus Gustavo Galindo Km. 30.5 Vía Perimetral, P.O. Box 09-01-5863, Guayaquil, Ecuador
| | - Angie Rendón-Riofrio
- Laboratorio para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral, ESPOL, Campus Gustavo Galindo Km. 30.5 Vía Perimetral, P.O. Box 09-01-5863, Guayaquil, Ecuador
| | - Gabriela A. Sanguña-Soliz
- Laboratorio para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral, ESPOL, Campus Gustavo Galindo Km. 30.5 Vía Perimetral, P.O. Box 09-01-5863, Guayaquil, Ecuador
- Escuela Superior Politécnica del Litoral, ESPOL, Centro de Agua y Desarrollo Sustentable, CADS, Campus Gustavo Galindo Km. 30.5 Vía Perimetral, P.O. Box 09-01-5863, Guayaquil, Ecuador
| | - Wim Vanden Berghe
- Epigenetic signaling PPES lab, Department Biomedical Sciences, University Antwerp, Antwerp, Belgium
| | - Andrea Orellana-Manzano
- Laboratorio para Investigaciones Biomédicas, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral, ESPOL, Campus Gustavo Galindo Km. 30.5 Vía Perimetral, P.O. Box 09-01-5863, Guayaquil, Ecuador
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12
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Nouri-Keshtkar M, Shojaei Shahrokhabadi M, Ghaheri A, Hosseini R, Ketabi H, Farjam M, Chen DG, Rezaeian M, Homayounfar R, Tahamtani Y, Totonchi M. Role of gender in explaining metabolic syndrome risk factors in an Iranian rural population using structural equation modelling. Sci Rep 2023; 13:16007. [PMID: 37749166 PMCID: PMC10520016 DOI: 10.1038/s41598-023-40485-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/10/2023] [Indexed: 09/27/2023] Open
Abstract
Many factors can lead to an increase in the prevalence of metabolic syndrome (MetS) in different populations. Using an advanced structural equation model (SEM), this study is aimed to determine the most important risk factors of MetS, as a continuous latent variable, using a large number of males and females. We also aimed to evaluate the interrelations among the associated factors involved in the development of MetS. This study used data derived from the Fasa PERSIAN cohort study, a branch of the PERSIAN cohort study, for participants aged 35 to 70 years with 10,138 males and females. SEM was used to evaluate the direct and indirect effects, as well as gender effects of influencing factors. Results from the SEM showed that in females most changes in MetS are described by waist circumference (WC), followed by hypertension (HP) and triglyceride (TG), while in males most changes in MetS are described by WC, followed by TG then fasting blood glucose (FBG). Results from the SEM confirmed the gender effects of social status on MetS, mediated by sleep and controlled by age, BMI, ethnicity and physical activity. This study also shows that the integration of TG and WC within genders could be useful as a screening criterion for MetS in our study population.
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Affiliation(s)
- Marjan Nouri-Keshtkar
- Department of Developmental Biology, University of Science and Culture, Tehran, Iran
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | | | - Azadeh Ghaheri
- Department of Basic and Population Based Studies in NCD, Reproductive Epidemiology Research Center, Royan Institute, ACECR, Tehran, Iran
| | - Roya Hosseini
- Department of Basic and Population Based Studies in NCD, Reproductive Epidemiology Research Center, Royan Institute, ACECR, Tehran, Iran
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Hassan Ketabi
- Mobile Telecommunication Company of Iran, Tehran, Iran
| | - Mojtaba Farjam
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Ding-Geng Chen
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
- Department of statistics, University of Pretoria, Pretoria, South Africa
| | - Mehdi Rezaeian
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Reza Homayounfar
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Yaser Tahamtani
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
- Department of Basic and Population Based Studies in NCD, Reproductive Epidemiology Research Center, Royan Institute, ACECR, Tehran, Iran.
| | - Mehdi Totonchi
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
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13
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Bilog NC, Mekoulou Ndongo J, Bika Lele EC, Guessogo WR, Assomo-Ndemba PB, Ahmadou, Etaga NB, Mbama Biloa YJ, Bindi JGBN, Temfemo A, Mandengue SH, Guyot J, Dupré C, Barth N, Bongue B, Etoundi Ngoa LS, Ayina Ayina CN. Prevalence of metabolic syndrome and components in rural, semi-urban and urban areas in the littoral region in Cameroon: impact of physical activity. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:95. [PMID: 37697395 PMCID: PMC10496244 DOI: 10.1186/s41043-023-00415-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/09/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Living areas in developing countries impact seriously lifestyle by modifying energy consumption and energy expenditure. Thus, urbanization is associated with less practice of physical activity (PA), a leading cause of metabolic syndrome (MetS) which prevalence vary in African countries. The present study aimed to assess the effect of PA on MetS according to urbanization level in the littoral region, Cameroon. METHODS A cross-sectional study was conducted in three geographical settings (urban, semi-urban, and rural) in the littoral region in Cameroon. A total of 879 participants were included (urban: 372, semi-urban: 195 and rural: 312). MetS was defined according to the International Federation of Diabetes 2009. The level of PA was assessed using the Global Physical Activity questionnaire. RESULTS Low level of PA was (P < 0.0001) reported in urban (54.5%), semi-urban (28.7%) and rural (16.9%) and high level in rural area (77.9%). The prevalence of MetS was higher in urban areas (37.2%), then rural (36.8%) and finally semi-urban (25.9%). Hyperglycemia (p = 0.0110), low HDL-c (p < 0.0001) and high triglyceridemia (p = 0.0068) were most prevalent in urban residents. Participants with low level of PA were at risk of MetS (OR: 1.751, 95% CI 1.335-2.731, p = 0.001), hyperglycemia (OR: 1.909, 95% CI 1.335-2.731, p = 0.0004) abdominal obesity(OR: 2.007, 95% CI 1.389-2.900, p = 0.0002), low HDL-c (OR: 1.539, 95% CI 1.088-2.179, p = 0.014) and those with moderate level of PA were protected against high blood pressure(OR: 0.452, 95% CI 0.298-0.686, p = 0.0002) and compared to those with high level of PA. Urban dwellers were at the risk of MetS compared to rural residents (OR: 1.708, 95% CI. 1.277-2.285, p = 0.003) and protected against high blood pressure (OR:0.314, 95% CI 0.212-0.466, p < 0.0001), abdominal obesity (OR: 0.570, 95% CI 0.409-0.794, p = 0.0009), and low HDL-c (OR: 0.725, 95% CI 0.534-0.983, p = 0.038) compared to rural residents. CONCLUSIONS MetS was more prevalent in urban dwellers and was associated with a low level of PA.
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Affiliation(s)
- Nadine Carole Bilog
- Department of Biology of Animal Organisms, Faculty of Science, University of Douala, Douala, Cameroun
- Exercise and Sport Physiology Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Jerson Mekoulou Ndongo
- Department of Biology of Animal Organisms, Faculty of Science, University of Douala, Douala, Cameroun
- Exercise and Sport Physiology Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Elysée Claude Bika Lele
- Department of Biology of Animal Organisms, Faculty of Science, University of Douala, Douala, Cameroun
- Exercise and Sport Physiology Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Wiliam Richard Guessogo
- Exercise and Sport Physiology Unit, Faculty of Science, University of Douala, Douala, Cameroon
- National Institute for Youth and Sports Yaounde, University of Yaounde I, Yaounde, Cameroon
| | - Peguy Brice Assomo-Ndemba
- Exercise and Sport Physiology Unit, Faculty of Science, University of Douala, Douala, Cameroon
- Department of Physiology, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - Ahmadou
- Department of Biology of Animal Organisms, Faculty of Science, University of Douala, Douala, Cameroun
- Exercise and Sport Physiology Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Noel Babayana Etaga
- Department of Biology of Animal Organisms, Faculty of Science, University of Douala, Douala, Cameroun
- Exercise and Sport Physiology Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | | | - Josiane Gertrude Bwegne Ngasse Bindi
- Department of Biology of Animal Organisms, Faculty of Science, University of Douala, Douala, Cameroun
- Exercise and Sport Physiology Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Abdou Temfemo
- Exercise and Sport Physiology Unit, Faculty of Science, University of Douala, Douala, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Samuel Honoré Mandengue
- Department of Biology of Animal Organisms, Faculty of Science, University of Douala, Douala, Cameroun
- Exercise and Sport Physiology Unit, Faculty of Science, University of Douala, Douala, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Jessica Guyot
- Mines Saint-Etienne, INSERM, SAINBIOSE U1059, 42023, Saint-Étienne, France
| | - Caroline Dupré
- Mines Saint-Etienne, INSERM, SAINBIOSE U1059, 42023, Saint-Étienne, France
| | - Nathalie Barth
- Mines Saint-Etienne, INSERM, SAINBIOSE U1059, 42023, Saint-Étienne, France
| | - Bienvenu Bongue
- Mines Saint-Etienne, INSERM, SAINBIOSE U1059, 42023, Saint-Étienne, France
| | - Laurent Serge Etoundi Ngoa
- Department of Animal Science, Higher Teacher's Training College, University of Yaoundé I, Yaounde, Cameroon
| | - Clarisse Noel Ayina Ayina
- Department of Biology of Animal Organisms, Faculty of Science, University of Douala, Douala, Cameroun.
- Exercise and Sport Physiology Unit, Faculty of Science, University of Douala, Douala, Cameroon.
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14
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Bowo-Ngandji A, Kenmoe S, Ebogo-Belobo JT, Kenfack-Momo R, Takuissu GR, Kengne-Ndé C, Mbaga DS, Tchatchouang S, Kenfack-Zanguim J, Lontuo Fogang R, Zeuko'o Menkem E, Ndzie Ondigui JL, Kame-Ngasse GI, Magoudjou-Pekam JN, Wandji Nguedjo M, Assam Assam JP, Enyegue Mandob D, Ngondi JL. Prevalence of the metabolic syndrome in African populations: A systematic review and meta-analysis. PLoS One 2023; 18:e0289155. [PMID: 37498832 PMCID: PMC10374159 DOI: 10.1371/journal.pone.0289155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 07/12/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND The metabolic syndrome (MS) is a leading cause of death worldwide. Several studies have found MS to be prevalent in various African regions. However, no specific estimates of MS prevalence in African populations exist. The aim of this study was to estimate the overall prevalence of MS in the African populations. METHODS A systematic review was conducted in PubMed, Web of Science, Africa Index Medicus, and African Journal Online Scopus to find studies published up to the 15th of August 2022. Pooled prevalence was calculated based on six diagnostic methods. The pooled prevalence of MS was estimated using a random-effects model. Our risk of bias analysis was based on the Hoy et al. tool. A Heterogeneity (I2) assessment was performed, as well as an Egger test for publication bias. PROSPERO number CRD42021275176 was assigned to this study. RESULTS In total, 297 studies corresponding to 345 prevalence data from 29 African countries and involving 156 464 participants were included. The overall prevalence of MS in Africa was 32.4% (95% CI: 30.2-34.7) with significant heterogeneity (I2 = 98.9%; P<0.001). We obtained prevalence rates of 44.8% (95% CI: 24.8-65.7), 39.7% (95% CI: 31.7-48.1), 33.1% (95% CI: 28.5-37.8), 31.6% (95% CI: 27.8-35.6) and 29.3% (95% CI: 25.7-33) using the WHO, revised NCEP-ATP III, JIS, NCEP/ATP III and IDF definition criteria, respectively. The prevalence of MS was significantly higher in adults >18 years with 33.1% (95%CI: 30.8-35.5) compared to children <18 years with 13.3% (95%CI: 7.3-20.6) (P<0.001). MS prevalence was significantly higher in females with 36.9% (95%CI: 33.2-40.7) compared to males with 26.7% (95%CI: 23.1-30.5) (P<0.001). The prevalence of MS was highest among Type 2 diabetes patients with 66.9% (95%CI: 60.3-73.1), followed by patients with coronary artery disease with 55.2% (95%CI: 50.8-59.6) and cardiovascular diseases with 48.3% (95%CI: 33.5-63.3) (P<0.001). With 33.6% (95% CI: 28.3-39.1), the southern African region was the most affected, followed by upper-middle income economies with 35% (95% CI: 29.5-40.6). CONCLUSION This study, regardless of the definition used, reveals a high prevalence of MS in Africa, confirming the ongoing epidemiological transition in African countries. Early prevention and treatment strategies are urgently needed to reverse this trend.
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Affiliation(s)
- Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Jean Thierry Ebogo-Belobo
- Institute of Medical Research and Medicinal Plants Studies, Medical Research Centre, Yaounde, Cameroon
| | - Raoul Kenfack-Momo
- Department of Biochemistry, The University of Yaounde I, Yaounde, Cameroon
| | - Guy Roussel Takuissu
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Cyprien Kengne-Ndé
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala, Cameroon
| | | | | | | | | | | | | | - Ginette Irma Kame-Ngasse
- Institute of Medical Research and Medicinal Plants Studies, Medical Research Centre, Yaounde, Cameroon
| | | | - Maxwell Wandji Nguedjo
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
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15
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Lonardo A. The heterogeneity of metabolic syndrome presentation and challenges this causes in its pharmacological management: a narrative review focusing on principal risk modifiers. Expert Rev Clin Pharmacol 2023; 16:891-911. [PMID: 37722710 DOI: 10.1080/17512433.2023.2259306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 09/12/2023] [Indexed: 09/20/2023]
Abstract
INTRODUCTION Metabolic syndrome (MetS), i.e. the cluster of cardiometabolic risk factors comprising visceral obesity, impaired glucose metabolism, arterial hypertension and atherogenic dyslipidemia, is prevalent globally and exacts a heavy toll on health care expenditures. AREAS COVERED The pathophenotypes of individual traits of the MetS in adults are discussed first, with strong emphasis on nonalcoholic fatty liver disease (NAFLD) and sex differences. Next, I discuss recent studies on phenotypic and outcome heterogeneity of the MetS, highlighting the role of NAFLD, sex, reproductive status, and depressive disorders. In the second half of the article, the therapeutic implications of the variable MetS types and features are analyzed, focusing on the most recent developments, and guidelines. EXPERT OPINION I have identified physiological, pathological, social and medical sources of phenotypical heterogeneity in the MetS and its constitutive traits. Improved understanding of these variables may be utilized in the setting of future precision medicine approaches in the field of metabolic disorders and target organ damage.
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Affiliation(s)
- Amedeo Lonardo
- Operating Unit of Metabolic Syndrome, Azienda Ospedaliero-Unversitaria di Modena, Ospedale Civile di Baggiovara, Baggiovara, Modena, Italy
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16
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Anto EO, Frimpong J, Boadu WIO, Korsah EE, Tamakloe VCKT, Ansah E, Opoku S, Acheampong E, Asamoah EA, Nyarkoa P, Adua E, Afrifa‐Yamoah E, Annani‐Akollor ME, Obirikorang C. Cardiometabolic syndrome among general adult population in Ghana: The role of lipid accumulation product, waist circumference-triglyceride index, and triglyceride-glucose index as surrogate indicators. Health Sci Rep 2023; 6:e1419. [PMID: 37441132 PMCID: PMC10333904 DOI: 10.1002/hsr2.1419] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Background Visceral obesity and insulin resistance contribute to developing cardiometabolic syndrome (MetS). We investigated the predictive abilities of lipid accumulation product (LAP), waist circumference-triglyceride index (WTI), and triglyceride-glucose (TyG) index for MetS screening among the general Ghanaian adults. Methods The final prospective analysis included 4740 healthy adults aged 30-90 years from three communities comprising Ejisu, Konongo, and Ashanti Akim Agogo in Ghana. Self-structured questionnaire pretested was used to collect sociodemographic, anthropometric, and clinical data. Blood samples were taken after fasting to measure glucose and lipid levels. LAP, WTI, and TyG were calculated from standard equations. MetS was defined by the International Diabetes Federation criteria. Receiver operating characteristic (ROC) curves and multivariable logistic regression were utilized to evaluate the potential of the three indices in identifying MetS. Results Of the 4740 participants, 39.7% had MetS. MetS was more common in females (50.3%) than in males (22.2%). Overall, LAP ≥ 27.52 yielded as the best index for MetS with the highest area under the ROC curve (AUC) (0.866). At cut-off LAP point of ≥23.87 in males and ≥33.32 in females, an AUC of 0.951 and 0.790 was identified in MetS prediction, respectively. LAP was an independent risk measure of MetS for both males (45.6-fold) and females (3.7-fold) whereas TyG was an independent risk measure for females (3.7-fold) only. Conclusions MetS is increasing among the general adult population. LAP and TyG are important sex-specific risk measures to screen for MetS among the general adult population in our cohort.
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Affiliation(s)
- Enoch O. Anto
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
- School of Medical and Health SciencesEdith Cowan UniversityPerthAustralia
| | - Joseph Frimpong
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Wina I. O. Boadu
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Emmanuel E. Korsah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Valentine C. K. T. Tamakloe
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Ezekiel Ansah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Stephen Opoku
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Emmanuel Acheampong
- School of Medical and Health SciencesEdith Cowan UniversityPerthAustralia
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Evans A. Asamoah
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Patience Nyarkoa
- Department of Physiology, School of Medicine and Dentistry, College of Health ScienceKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Eric Adua
- Rural Clinical School, Medicine and HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | | | - Max E. Annani‐Akollor
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Christian Obirikorang
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
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17
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Charkos TG, Getnet M. Metabolic syndrome in patients with type 2 diabetes mellitus at Adama Hospital Medical College, Ethiopia: a hospital-based cross-sectional study. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2023; 4:1165015. [PMID: 37396441 PMCID: PMC10311433 DOI: 10.3389/fcdhc.2023.1165015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/08/2023] [Indexed: 07/04/2023]
Abstract
Background Metabolic syndrome is one of the most serious global public health problems. It is associated with a higher risk of heart attack and other cardiovascular diseases. However, the magnitude of metabolic syndrome among patients with type 2 diabetes mellitus is not well understood, especially in developing countries such as Ethiopia. Objective To determine the magnitude of metabolic syndrome and associated factors among type 2 diabetes mellitus patients at Adama Hospital Medical College, Ethiopia, in 2022. Method A facility-based cross-sectional study was conducted from September 1 to October 30, 2022. The data was collected through a self-administered questionnaire. A systematic random sampling method was used to select the participants. Data were entered using Epi Info version 7.2 and analyzed by SPSS version 23. Multivariable logistic regression was used to model this study. Statistical significance was set at p-values of < 0.05. Result A total of 237 participants were included in this study, with a response rate of 95.1%. Overall, the magnitude of metabolic syndrome was 53.2% (95% CI: 46.8 - 59.6), 41.3% (95% CI: 35.0 - 47.5), and 41.8% (95% CI: 35.5 - 48.1) based on 2009 harmonized criteria of MetS, Revised National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), and International Diabetes Federation (IDF) criteria, respectively. In multivariable logistic analysis, urban residence (AOR=3.07, 95% CI: 1.46-6.42), earning a high income (AOR=5.87 95% CI: 1.8-19.1), history of cardiac illness (AOR=3.33, 95% CI: 1.41-7.84), history of hypertension (AOR=2.65, 95% CI: 1.22-5.78), dyslipidemia (AOR=4.47, 95% CI: 1.96-10.19), current cigarette smoker (AOR=6.2, 95% CI: 1.7-22.93), sedentary activity (AOR=3.62, 95% CI: 1.68-7.82), use of palm oil (AOR=4.87, 95% CI: 2.06-11.51), and BMI ≥25 kg/m2 (AOR=3.36, 95% CI: 1.57-7.16) were significantly associated with metabolic syndrome. Conclusion The findings of this study suggested that the magnitude of metabolic syndrome among T2DM patients was high. We found consistent results using the NCEP-ATP III and IDF criteria. Similarly, urban residence, high income, history of cardiac, history of hypertension, dyslipidemia, current cigarette smoker, sedentary activity, palm oil, and BMI ≥25 kg/m2 were significantly associated with metabolic syndrome.
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Affiliation(s)
| | - Menberu Getnet
- Department of Internal Medicine, Adama Hospital Medical College, Adama, Ethiopia
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18
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Ong J, Alswat K, Hamid S, El-Kassas M. Nonalcoholic Fatty Liver Disease in Asia, Africa, and Middle East Region. Clin Liver Dis 2023; 27:287-299. [PMID: 37024208 DOI: 10.1016/j.cld.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide. The global prevalence of the disease varies according to the geographical region. Despite having distinct models for the western patterns of NAFLD, Africa, Asia, and the Middle East regions exhibited varying prevalence rates of NAFLD. The disease burden is anticipated to significantly increase in these areas. Furthermore, with an increase in NAFLD risk factors in these regions, the disease burden is expected to rise even more. Policies at the regional and international levels are required to address such growing burden of NAFLD consequences.
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Affiliation(s)
- Janus Ong
- College of Medicine, University of the Philippines, Manila, Philippines
| | - Khalid Alswat
- Department of Medicine, Liver Disease Research Centre, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saeed Hamid
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Mohamed El-Kassas
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Ain Helwan, Cairo 11795, Egypt.
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19
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Association between Poor Quality of Sleep and Metabolic Syndrome in Ghanaian University Students: A Cross-Sectional Study. SLEEP DISORDERS 2022; 2022:8802757. [PMID: 36276192 PMCID: PMC9581681 DOI: 10.1155/2022/8802757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/21/2022] [Indexed: 11/18/2022]
Abstract
Aim. This study aimed to determine the association between quality of sleep and metabolic syndrome (MetS) and physical activity level in young adults at the University of Ghana. Method. In a cross-sectional design, 340 university students, aged between 20-30 years were recruited. Quality of sleep was assessed using the Pittsburgh Sleep Quality index (PSQI) and physical activity with the short form of the International Physical Activity Questionnaire (IPAQ-SF). Poor quality of sleep was defined as a global PSQI score>5 and low physical activity level as those not meeting the criteria for vigorous-moderate physical activity. Anthropometric features and blood pressures were measured, and fasting blood samples were collected from the participants to measure plasma levels of glucose, lipid profile, urea, and creatinine. MetS was defined using the Joint Scientific Statement criteria. Results. In our study population of young adults from Ghana, the prevalence of poor quality of sleep as measured by PSQI was 54.1%, and MetS was 12.4%. MetS was associated with poor quality of sleep in females [
(1.04–4.25),
] and entire study participants [2.18 (1.09–4.37)
] in both crude and adjusted models; no association was found in male participants. Low physical activity status was not associated with poor sleep status. Obesity [1.32 (1.02–3.56),
], but not overweight [0.99 (0.58–2.34),
], was associated with poor quality of sleep. Conclusion. Young adults in a Ghanaian university have a high prevalence of poor quality of sleep and is associated with MetS and obesity. Physical activity status was not associated with poor quality of sleep.
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Achempim-Ansong G, Tshabalala AM, Gradidge PJ. Factors Associated with Improved Knowledge of Metabolic Syndrome in Female Market Traders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12256. [PMID: 36231550 PMCID: PMC9565965 DOI: 10.3390/ijerph191912256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/23/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
Metabolic syndrome (MetS) is considered to be a clustering of cardiometabolic diseases and is emerging as a public health concern. There is little evidence of this disease in market traders, and so the aim of this study was to determine the prevalence and knowledge of MetS. In this cross-sectional study, anthropometry, blood pressure and bloods were collected using standardized methods to detect the prevalence of MetS using the harmonized method in a cohort of female Ghanaian market traders (n = 338). A questionnaire documented the knowledge of MetS. Linear regression was used to investigate the factors associated with knowledge and was reported as adjusted β values. Forty-two percent (n = 142) had MetS. The overall knowledge of MetS was low, driven by education (β = 0.22, p = 0.0001), low levels of high-density lipoprotein-cholesterol (β = -0.15, p = 0.018) and affiliation with the Ewe cultural group (β = -0.19, p = 0.0004). As females working in a sedentary occupation, market traders are vulnerable to MetS. Our findings indicate the urgent need for culturally sensitive education to promote healthy behaviours.
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Affiliation(s)
- Gloria Achempim-Ansong
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Amme M. Tshabalala
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Philippe J. Gradidge
- Centre for Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
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21
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Kentoffio K, Durstenfeld MS, Siedner MJ, Kityo C, Erem G, Ssinabulya I, Ghoshhajra B, Bittencourt MS, Longenecker CT. Sex-specific performance of the ASCVD pooled cohort equation risk calculator as a correlate of coronary artery calcium in Kampala, Uganda. INTERNATIONAL JOURNAL OF CARDIOLOGY CARDIOVASCULAR RISK AND PREVENTION 2022; 14:200136. [PMID: 36060290 PMCID: PMC9434411 DOI: 10.1016/j.ijcrp.2022.200136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/03/2022] [Accepted: 05/19/2022] [Indexed: 11/29/2022]
Abstract
Introduction: The prevalence of cardiovascular disease (CVD) is rising in Sub-Saharan Africa, but it is not known whether current risk assessment tools predict coronary atherosclerosis in the region. Furthermore, sex-specific performance and interaction with HIV serostatus has not been well studied. Methods: This cross-sectional study compared ASCVD risk scores and detectable coronary artery calcium (CAC>0) by sex in Kampala, Uganda (n = 200). The cohort was enriched for persons living with HIV, and all participants had at least one CVD risk factor. We fit log binomial regression models and constructed ROC curves to assess the correlation between ASCVD scores and CAC>0. Results: The mean age was 56. 62% were female and 50% of both men and women were living with HIV. The median 10-year ASCVD risk score was significantly higher in men (11.0%, IQR 7.6–19.4%) than in women (5.1%, IQR 3.2–8.7%), although the prevalence of CAC>0 was similar (8.1 vs 10.5%, p = 0.63). Each 10% increase in ASCVD risk was associated with increased risk of CAC>0 in men (PR 1.59, 95% CI 1.00–2.55, p = 0.05) but not women (PR 1.15, 95% CI 0.44–3.00, p = 0.77). ROC curves demonstrated an AUC of 0.57 for women vs 0.70 for men. Adjustment for HIV serostatus improved the predictive value of ASCVD in women only (AUC 0.78, p = 0.02). Conclusions: ASCVD risk score did not correlate with the presence of CAC in women. When HIV status was added to the ASCVD risk score, correlation with CAC was improved in women but not in men.
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Affiliation(s)
- Katherine Kentoffio
- Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Matthew S. Durstenfeld
- Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Mark J. Siedner
- Massachusetts General Hospital, Center for Global Health, Boston, MA, USA
- Mbarara University of Science and Technology, Mbarara, Uganda
- Harvard Medical School, Boston, MA, USA
| | - Cissy Kityo
- HIV Medicine, Joint Clinical Research Centre, Kampala, Uganda
| | - Geoffrey Erem
- Department of Radiology, St Francis Hospital Nsambya, Kampala, Uganda
- Departments of Radiology and Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Isaac Ssinabulya
- Departments of Radiology and Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Cardiology, Uganda Heart Institute, Kampala, Uganda
| | - Brian Ghoshhajra
- Harvard Medical School, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Marcio S. Bittencourt
- Center for Clinical and Epidemiological Research, University Hospital, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Chris T. Longenecker
- Department of Global Health and Division of Cardiology, University of Washington, Seattle, WA, USA
- Corresponding author. Global Cardiovascular Health Program, University of Washington School of Medicine, Department of Global Health, Hans Rosling Center Room 721, Guthrie Annex 3, Seattle, WA, 98105, USA.
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22
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Gradidge PJ, Norris SA, Crowther NJ. The Effect of Obesity on the Waist Circumference Cut-Point Used for the Diagnosis of the Metabolic Syndrome in African Women: Results from the SWEET Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610250. [PMID: 36011884 PMCID: PMC9407919 DOI: 10.3390/ijerph191610250] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 05/27/2023]
Abstract
Waist circumference (WC) is one of the diagnostic criteria for metabolic syndrome (MetS). However, studies have shown that the waist cut-point may be influenced by BMI. The aim of this study was to, therefore, determine whether the presence of obesity influences the WC cut-point used to diagnose MetS in sub-Saharan African women. The second aim was to determine whether calculated cut-points of other waist-related and dual-energy X-ray absorptiometry (DXA)-determined anthropometric measures used for the diagnosis of MetS were also influenced by BMI. Biochemical, simple anthropometric and dual-energy X-ray absorptiometry-derived anthropometric data were collected in 702 black South African women from the Study of Women Entering and in Endocrine Transition (SWEET). A receiver operating characteristic curve analysis was used to determine waist, waist-to-hip (WHR) and waist-to-height ratios, body shape index (ABSI), total body fat, trunk fat, and peripheral (arm + leg) fat cut-points for MetS (without waist) in subjects with BMI above or below the median value. The estimated WC cut-points (107 cm, 93.5 cm) for women with high BMI and low BMI, respectively, and the cut-points for the other anthropometric variables for the diagnosis of MetS were greater in high BMI women compared to low BMI women. The exceptions were WHR and ABSI, for which the cut-points were very similar in both BMI groups, and peripheral fat, where the cut-point was lower in the high BMI group. Logistic regression analysis demonstrated that WC was associated with a higher risk (odds ratio [95% CIs]: 1.07 [1.04, 1.10]; p < 0.0001), whilst hip was associated with a lower risk (0.97 [0.94, 0.99]; p = 0.02) for MetS. These data suggest that with increasing BMI, the higher levels of protective gluteofemoral fat lead to the requirement for higher WC cut-points for MetS diagnosis. The opposing associations of waist and hip with MetS risk make WHR a more appropriate variable for diagnosing MetS among African women as the WHR cut-point is less influenced by increasing BMI than is WC, which was also observed for ABSI.
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Affiliation(s)
- Philippe J. Gradidge
- Centre for Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Shane A. Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Nigel J. Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2050, South Africa
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23
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Sundarakumar JS, Stezin A, Menesgere AL, Ravindranath V. Rural-urban and gender differences in metabolic syndrome in the aging population from southern India: Two parallel, prospective cohort studies. EClinicalMedicine 2022; 47:101395. [PMID: 35497067 PMCID: PMC9044001 DOI: 10.1016/j.eclinm.2022.101395] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/18/2022] [Accepted: 03/28/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Despite the growing evidence of metabolic syndrome as a major risk factor for cardiovascular and cerebrovascular disease, there are limited studies from India on its prevalence, especially in the aging population. We aimed to estimate the prevalence of metabolic syndrome and associated comorbidities in two prospective, aging cohorts from rural and urban India. METHODS In these two parallel, prospective, aging (≥ 45 years) cohorts, the samples included 2171 people from rural India (Srinivaspura Aging, Neuro Senescence and COGnition, SANSCOG cohort; April 23, 2018 to Sept 25, 2021) and 332 people from urban India (Tata Longitudinal Study on Aging, TLSA cohort; July 8, 2015 to Oct 23, 2021). Using cross-sectional data from baseline clinical and biochemical assessments, we calculated metabolic syndrome prevalence using two well established criteria, namely consensus criteria and National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III) criteria; further, rural-urban, gender, and age-wise differences were compared. FINDINGS Proportions of metabolic syndrome were 46.2 and 54.8% as per consensus criteria in rural and urban participants, respectively; corresponding numbers using NCEP-ATP III criteria were 40.3 and 45.1%. Rural-dwelling older adults had a significantly lesser prevalence of all individual metabolic syndrome parameters except impaired triglycerides and high-density lipoprotein levels. Rural women had a significantly higher prevalence of metabolic syndrome than rural men, whereas there was no significant difference among urban participants. We did not observe any consistent age-wise trend when comparing both cohorts. There was high burden of comorbidities among both groups, mostly undiagnosed in rural participants. INTERPRETATION Roughly one in two older adults had metabolic syndrome, urban significantly more than rural, reaching an alarming 63.1% among urban participants aged 65-74 years. The very high prevalence of undiagnosed co-morbidities among rural adults is extremely concerning, calling for urgent public health measures in this marginalised and health-disparate population. FUNDING SANSCOG study is funded through the Centre for Brain Research (CBR), Indian Institute of Science (IISc) by Pratiksha Trust, the philanthropic arm of Mr. Kris Gopalakrishnan. TLSA is funded by Tata Trusts.
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Tesfay FH, Backholer K, Zorbas C, Bowe SJ, Alston L, Bennett CM. The Magnitude of NCD Risk Factors in Ethiopia: Meta-Analysis and Systematic Review of Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095316. [PMID: 35564716 PMCID: PMC9106049 DOI: 10.3390/ijerph19095316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/15/2022] [Accepted: 04/20/2022] [Indexed: 02/04/2023]
Abstract
Background: Non-communicable Diseases (NCDs) and their risk factors are the leading contributors to morbidity and mortality globally, particularly in low- and middle-income countries including Ethiopia. To date, there has been no synthesis of the literature on the relative prevalence of NCD risk factors in Ethiopia. Methodology: We conducted a systematic review and meta-analysis of primary studies reporting on the prevalence of NCD risk factors in Ethiopia published in English from 2012 to July 2020. Pre-tested NCD search terms were applied to Medline, Embase, Scopus, CINAHL, and Global Health. Three reviewers screened and appraised the quality of the identified papers. Data extraction was conducted using a pilot tested proforma. Meta-analysis was conducted using Stata 16 and pooled prevalence estimated with associated 95% confidence intervals. Clinically heterogeneous studies that did not fulfil the eligibility criteria for meta-analysis were narratively synthesised. I2 was used to assess statistical heterogeneity. Results: 47 studies fulfilled the inclusion criteria and contributed 68 NCD risk factor prevalence estimates. Hypertension was the most frequently examined NCD risk factor, with a pooled prevalence of 21% (n = 27 studies). The pooled prevalence percentages for overweight and obesity were 19.2% and 10.3%, respectively (n = 7 studies each), with a combined prevalence of 26.8% (n = 1 study). It was not possible to pool the prevalence of alcohol consumption, smoking, metabolic disorders, or fruit consumption because of heterogeneity across studies. The prevalence of alcohol use, as reported from the included individual studies, ranged from 12.4% to 13.5% (n = 7 studies). More than 90% of participants met the WHO-recommended level of physical activity (n = 5 studies). The prevalence of smoking was highly variable, ranging between 0.8% and 38.6%, as was the prevalence of heavy alcohol drinking (12.4% to 21.1%, n = 6 studies) and metabolic syndrome (4.8% to 9.6%, n = 5 studies). Fruit consumption ranged from 1.5% up to the recommended level, but varied across geographic areas (n = 3 studies). Conclusion and recommendations: The prevalence of NCD risk factors in Ethiopia is relatively high. National NCD risk factor surveillance is required to inform the prioritisation of policies and interventions to reduce the NCD burden in Ethiopia.
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Affiliation(s)
- Fisaha Haile Tesfay
- Institute for Health Transformation, Deakin University, Geelong 3220, Australia; (K.B.); (C.Z.); (L.A.); (C.M.B.)
- College of Medicine and Public Health, Flinders University, Adelaide 5042, Australia
- College of Medicine and Health Sciences, School of Public Health, Mekelle University, Mekelle P.O. Box 231, Ethiopia
- Correspondence:
| | - Kathryn Backholer
- Institute for Health Transformation, Deakin University, Geelong 3220, Australia; (K.B.); (C.Z.); (L.A.); (C.M.B.)
| | - Christina Zorbas
- Institute for Health Transformation, Deakin University, Geelong 3220, Australia; (K.B.); (C.Z.); (L.A.); (C.M.B.)
| | - Steven J. Bowe
- Deakin Biostatistics Unit, Faculty of Health, Deakin University, Geelong 3220, Australia;
| | - Laura Alston
- Institute for Health Transformation, Deakin University, Geelong 3220, Australia; (K.B.); (C.Z.); (L.A.); (C.M.B.)
| | - Catherine M. Bennett
- Institute for Health Transformation, Deakin University, Geelong 3220, Australia; (K.B.); (C.Z.); (L.A.); (C.M.B.)
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25
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Bojang KS, Lyrawati D, Sujuti H, Wahono D. Prevalence of Metabolic Syndrome and its Components in Kanifing Municipality, The Gambia. Med Arch 2022; 75:340-346. [PMID: 35169354 PMCID: PMC8740674 DOI: 10.5455/medarh.2021.75.340-346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/15/2021] [Indexed: 11/03/2022] Open
Abstract
Background Metabolic syndrome (MetS) is a complex syndrome with clustering of interrelated risk factors for cardiovascular disease and diabetes. Its rising worldwide prevalence has been largely related to the increasing obesity. In The Gambia, the last and only time a MetS related study was conducted, and then reported, was 21 years. Therefore, there is need for evaluating the prevalence of MetS and its components in the country. Objective This study was aimed to evaluate the prevalence of MetS and its individual components in Kanifing Municipality (KM). Methods It was a cross-sectional study conducted at Kanifing General Hospital, Kanifing Municipality. Data obtained from each participants included anthropometric indices, blood pressure, fasting plasma glucose, triglyceride and high-density lipoprotein levels, and clinical information. Results One hundred and thirty-six participants were included in the analysis. The overall MetS prevalence was 54.4% with significant female predominance (female, 58%; male, 29.4%; P=0.025). The most predominant component among the study population was central obesity (raised WC) (72.8%). Hypertriglyceridemia was found to be the strongest predictor of MetS among our participants (OR: 118.13; 95% CI: 33.79-412.77; P < 0.001). Conclusion Our study discloses a very high prevalence of MetS among the participants, and a significant female predominance, with central obesity the commonest Mets component. The results suggest that hypertriglyceridemia is the strongest predictor of metabolic syndrome in our study participants.
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Affiliation(s)
- Kebba S Bojang
- Doctoral Program, Postgraduate Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia.,School of Medicine and Allied Health Sciences, University of The Gambia, Banjul, The Gambia.,Department of Internal Medicine, Kanifing General Hospital, Kanifing, The Gambia
| | - Diana Lyrawati
- Doctoral Program, Postgraduate Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia.,Department of Pharmacy, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Hidayat Sujuti
- Doctoral Program, Postgraduate Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia.,Department of Ophthalmology, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Djoko Wahono
- Doctoral Program, Postgraduate Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia.,Department of Internal Medicine, Faculty of Medical, Brawijaya University, Malang, Indonesia
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Metabolic Syndrome and Its Components among Taxi Drivers in the City of Tshwane, South Africa. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031767] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The occupation of taxi driving predisposes drivers to health risks, including obesity, cardiovascular and metabolic disorders. Although individual components of metabolic syndrome (MetS) are documented, data is scarce on concurrent metabolic disturbances among commercial drivers. The prevalence of MetS and its components were determined in a cross-sectional study among taxi drivers (n = 362) in the City of Tshwane, South Africa. Sociodemographic, occupational, and lifestyle factors were assessed using a structured questionnaire. Anthropometry, blood pressure, and glucose were measured. MetS was defined based on BMI strata, hypertension, and glucose levels. Data was analyzed using SPSS. The mean age of taxi drivers was 42 ± 10.9 years. Overall prevalence of MetS was 17.1%, with higher prevalence observed among older taxi drivers (24.2%) and those with longer experience in the industry (22.9%). Individual components of MetS were obesity (36%), hypertension (36%) and diabetes (46%), while smoking (30%), alcohol use (59%), and physical inactivity (71%) were observed. MetS was associated with duration in the taxi industry, and family history of diabetes among taxi drivers. The presence of MetS and its components among taxi drivers calls for early identification of cardiometabolic risks in the taxi industry and efforts towards achieving a healthier workforce.
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Li W, Qiu X, Ma H, Geng Q. Incidence and long-term specific mortality trends of metabolic syndrome in the United States. Front Endocrinol (Lausanne) 2022; 13:1029736. [PMID: 36733801 PMCID: PMC9886893 DOI: 10.3389/fendo.2022.1029736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 12/30/2022] [Indexed: 01/19/2023] Open
Abstract
PURPOSE Metabolic syndrome (MetS) is extremely prevalent and related to severe diseases and death. This study aims to investigate the incidence and mortality trends among MetS over the past few decades. The gender and age differences of MetS are also explored. PATIENTS AND METHODS Adults with MetS were screened in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014. The mortality data were also acquired. Then we assessed the incidence and mortality trends of MetS in the United States. RESULTS Our study included 14171 participants with a mean age of 46.8 ± 19.3 years, of whom 7354 (51.9%) were women. Among them, 4789 participants were subsequently diagnosed with MetS. From 1999 to 2014, the overall trend of MetS incidence increased (from 27.6 to 32.3%; adjusted odds ratios [aOR], 1.71; 95% confidence interval [CI], 1.42-2.05; P-value <0.001, P for trend <0.001). In more detail, the incidence of MetS rose first but subsequently plateaued and declined. Obvious downward trends were observed from 29.6 to 2.7% for all-cause mortality (aOR, 0.12; 95%CI, 0.07-0.21; P-value <0.001, P for trend <0.001) and 4.8 to 0.8% for cardio-cerebrovascular mortality (aOR, 0.17; 95%CI, 0.05-0.61; P-value =0.007, P for trend <0.001). All-cause mortality decreased yearly, whereas cardio-cerebrovascular death increased briefly before declining and stabilizing. Similarly, the temporal mortality trends in MetS patients of different ages and genders had the same results. Specifically, the incidence of MetS was higher in women than in men (adjusted P =0.003; OR, 1.14; 95%CI, 1.05-1.24), but the mortality was significantly lower after an average of 7.7 years of follow-up (all-cause mortality, adjusted P <0.001; hazard ratio [HR], 0.68; 95%CI, 0.57-0.81; cardio-cerebrovascular mortality, adjusted P =0.004; HR, 0.55; 95%CI, 0.37-0.83). CONCLUSION From 1999 to 2014, the incidence of MetS in U.S. adults significantly increased overall, while the mortality rate of MetS had a considerable downward trend. Both trends showed marked gender differences, being more prevalent and at lower risk in women compared with men. It is important to identify the factors that will curb the incidence of MetS and decrease mortality, especially in male patients.
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Affiliation(s)
| | | | - Huan Ma
- *Correspondence: Huan Ma, ; Qingshan Geng,
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Nizigiyimana P, Xu B, Liu L, Luo L, Liu T, Jiang M, Liu Z, Li C, Luo X, Lei M. Gut microbiota is associated with differential metabolic characteristics: A study on a defined cohort of Africans and Chinese. Front Endocrinol (Lausanne) 2022; 13:942383. [PMID: 36246928 PMCID: PMC9554505 DOI: 10.3389/fendo.2022.942383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study intended to determine the associations between gut microbiota and glucose response in healthy individuals and analyze the connection between the gut microbiome and glucose-metabolism-related parameters. METHODS Fecal bacterial composition and anthropometric, body composition, body fat distribution, and biochemical measures were analyzed. A 75-g oral glucose tolerance test (OGTT) was given to each participant to investigate changes in glucagon-like peptide 1 (GLP-1), insulin, and glucose. The whole body fat and the regions of interest of local body composition were analyzed using dual-energy X-ray absorptiometry (DEXA), and gut microbiota composition was assessed through variable regions (V3-V4) of the bacterial 16s ribosomal RNA gene using high-throughput sequencing techniques. Spearman correlation analysis was used to evaluate the association between gut microbiota and clinical and metabolic changes. RESULTS The number of operational taxonomic units (OTUs) demonstrated a reduction in the diversity and composition of gut microbiota associated with enhanced adiposity, dyslipidemia, insulin resistance, and hyperglycemia. The alpha diversity revealed that microbiota diversity, richness, and composition were higher in the African group and lower in the Chinese group. Principal coordinates analysis (PCoA) plots of beta diversity showed significant variability in gut microbial community structure between the two groups (p = 0.0009). LEfSe analysis showed that phylum Bacteroidetes was significantly more abundant in the Chinese group, and this group also harbored members of the order Bacteroidales, family Bacteroidaceae, and genus Bacteroides. In contrast, the phylum Verrucomicrobia was significantly more prevalent in the African group (all p < 0.05). Concerning species, metastats analysis revealed 8 species in the Chinese group and 18 species in the African group that were significantly abundant. Spearman's correlation analysis demonstrated that gut microbiota correlated with the factors that related to glucose metabolism. CONCLUSION Our data suggest that there is an interaction between gut microbiota, host physiology, and glucometabolic pathways, and this could contribute to adiposity and pathophysiology of hyperlipidemia, insulin resistance, and hyperglycemia. These findings provide an important basis for determining the relation between the gut microbiota and the pathogenesis of various metabolic disorders.
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Affiliation(s)
- Paul Nizigiyimana
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, China
| | - Boya Xu
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, China
| | - Lerong Liu
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, China
| | - Liping Luo
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, China
| | - Tingting Liu
- Department of Endocrinology, Haikou Hospital Affiliated to Xiangya School of Medicine, Central South University, Haikou, China
| | - Meng Jiang
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, China
| | - Zehao Liu
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, China
| | - Changjun Li
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, China
| | - Xianghang Luo
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, China
| | - Minxiang Lei
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Minxiang Lei,
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Šeda O. Parental overnutrition by carbohydrates in developmental origins of metabolic syndrome. Physiol Res 2021; 70:S585-S596. [DOI: 10.33549/physiolres.934806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
interplay of genomic component and the exposome. Parental diet has been shown to affect offspring metabolic health via multiple epigenetic mechanisms. Excess carbohydrate intake is one of the driving forces of the obesity and metabolic syndrome pandemics. This review summarizes the evidence for the effects of maternal carbohydrate (fructose, sucrose, glucose) overnutrition on the modulation of metabolic syndrome components in the offspring. Despite substantial discrepancies in experimental design, common effects of maternal carbohydrate overnutrition include increased body weight and hepatic lipid content of the "programmed" offspring. However, the administration of sucrose to several rat models leads to apparently favorable metabolic outcomes. Moreover, there is evidence for the role of genomic background in modulating the metabolic programming effect in the form of nutri-epigenomic interaction. Comprehensive, robust studies are needed to resolve the temporal, sex-specific, genetic, epigenetic and nutritional aspects of parental overnutrition in the intergenerational and transgenerational pathogenesis of metabolic syndrome.
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Šeda O. Parental overnutrition by carbohydrates in developmental origins of metabolic syndrome. Physiol Res 2021. [DOI: 10.33549//physiolres.934806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Metabolic syndrome is a prevalent disease resulting from an interplay of genomic component and the exposome. Parental diet has been shown to affect offspring metabolic health via multiple epigenetic mechanisms. Excess carbohydrate intake is one of the driving forces of the obesity and metabolic syndrome pandemics. This review summarizes the evidence for the effects of maternal carbohydrate (fructose, sucrose, glucose) overnutrition on the modulation of metabolic syndrome components in the offspring. Despite substantial discrepancies in experimental design, common effects of maternal carbohydrate overnutrition include increased body weight and hepatic lipid content of the "programmed" offspring. However, the administration of sucrose to several rat models leads to apparently favorable metabolic outcomes. Moreover, there is evidence for the role of genomic background in modulating the metabolic programming effect in the form of nutri-epigenomic interaction. Comprehensive, robust studies are needed to resolve the temporal, sex-specific, genetic, epigenetic and nutritional aspects of parental overnutrition in the intergenerational and transgenerational pathogenesis of metabolic syndrome.
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Affiliation(s)
- O Šeda
- Institute of Biology and Medical Genetics, the First Faculty of Medicine, Charles University and the General University Hospital, Prague, Czech Republic
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Xiong Y, Zhang Y, Zhang F, Wu C, Qin F, Yuan J. Prevalence and associated factors of metabolic syndrome in Chinese middle-aged and elderly population: a national cross-sectional study. Aging Male 2021; 24:148-159. [PMID: 34751610 DOI: 10.1080/13685538.2021.1998432] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Currently, China has an increasingly aging population. However, the prevalence of metabolic syndrome (MetS) in this high-risk population for metabolic diseases remains unknown. This study investigates the age- and gender-specific prevalence and associated factors of MetS in the middle-aged and elderly Chinese population. METHODS Data were collected and subjected to descriptive statistics. Further, univariate logistic regression was used to evaluate the relevant factors, and then multivariate logistic regression was selected to construct the final model. RESULTS A total of 10,834 participants were included in the present study. The overall prevalence of MetS is 32.97% as defined by International Diabetes Federation (IDF) and 29.75% under National Cholesterol Education Program-The Adult Treatment Panel III (NCEP-ATP III) criteria. With aging, the prevalence of MetS descends in males while ascends in females. In the >70 years old group, the prevalence of MetS is three times higher in females than that in males (50.43% versus 16.03%). Across all age groups and sexes, the prevalence of MetS in urban areas is significantly higher than in rural areas. Besides, regardless of gender, the prevalence of MetS is the highest for those living in the north region (28.41% for males and 51.74% for females) and the lowest for those living in the southwest region (13.91% for males and 31.58% for females). Finally, an afternoon nap has been identified as a positively associated factor, while blood urea nitrogen (BUN) has been identified as a negatively associated factor (p < 0.05). CONCLUSION The prevalence of MetS varies in different age groups, sexes, living areas, and regions. An afternoon nap is positively associated with the prevalence of MetS, while BUN is negatively associated with MetS.
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Affiliation(s)
- Yang Xiong
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yangchang Zhang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Fuxun Zhang
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Changjing Wu
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Feng Qin
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Jiuhong Yuan
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
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van der Heijden TGW, Chilunga FP, Meeks KAC, Addo J, Danquah I, Beune EJ, Bahendeka SK, Klipstein-Grobusch K, Mockenhaupt FP, Waltz MM, Agyemang C. The Magnitude and Directions of the Associations between Early Life Factors and Metabolic Syndrome Differ across Geographical Locations among Migrant and Non-Migrant Ghanaians-The RODAM Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211996. [PMID: 34831754 PMCID: PMC8622143 DOI: 10.3390/ijerph182211996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/05/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Early-life factors (ELFs) such as childhood nutrition and childhood socio-economic status could be the drivers of the increase in metabolic syndrome (MetSyn) among African populations, but data are lacking. This study evaluated whether markers of childhood nutritional status and childhood socio-economic status were associated with MetSyn in adulthood among migrant Ghanaians living in Europe and non-migrant Ghanaians living in Ghana. METHODS Data from the Research on Obesity and Diabetes among African Migrants (RODAM) study, involving 2008 migrants and 2320 non-migrants aged ≥25 years, were analysed for this study. We used leg-length to height ratio (LHR), which is an anthropometric marker of childhood nutritional status, and parental education, which is a marker of childhood socio-economic status, as proxies. Adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) were calculated by logistic regression with adjustments for demographic and lifestyle factors. RESULTS Parental education was higher among Ghanaians in Europe than among residents in rural and urban Ghana. The prevalence of MetSyn was 18.5%, 27.7% and 33.5% for rural, urban, and migrant residents, respectively. LHR was inversely associated with MetSyn among migrants. Compared with high paternal education, individuals with low paternal education had lower odds of MetSyn in migrants (AOR 0.71 95% CI 0.54-0.94). In contrast, compared with high maternal education, individuals with intermediate maternal education had higher odds of MetSyn in urban Ghanaians (AOR 4.53 95% CI 1.50-3.74). No associations were found among rural Ghanaians. CONCLUSION The magnitude and direction of the associations between ELFs and MetSyn differ across geographical locations. Intermediate maternal education was positively associated with MetSyn among urban Ghanaians, while LHR and low paternal education were inversely associated with MetSyn among migrant Ghanaians. Further research into the interplay of genetics, environment and behaviour is needed to elucidate the underlying pathological mechanisms of MetSyn amongst migrants.
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Affiliation(s)
- Thijs G. W. van der Heijden
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.J.B.); (C.A.)
- Correspondence:
| | - Felix P. Chilunga
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.J.B.); (C.A.)
| | - Karlijn A. C. Meeks
- Center for Research on Genomics & Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20894, USA;
| | - Juliet Addo
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
| | - Ina Danquah
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, 69120 Heidelberg, Germany;
| | - Erik J. Beune
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.J.B.); (C.A.)
| | - Silver K. Bahendeka
- Mother Kevin Postgraduate Medical School (MKPGMS), Uganda Martyrs University, Kampala 32297, Uganda;
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre, Utrecht University, 3584 CG Utrecht, The Netherlands;
- Division of Epidemiology and Biostatistics, Department of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Frank P. Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, 13353 Berlin, Germany;
| | - Mitzi M. Waltz
- Athena Institute, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands;
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.J.B.); (C.A.)
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Dele-Ojo BF, Raimi TH, Fadare JO, Dada SA, Ajayi EA, Ajayi DD, Ogunmodede JA, Ajayi AO. Association between metabolic syndrome and healthcare work status in Ekiti State, Nigeria. Pan Afr Med J 2021; 39:257. [PMID: 34707758 PMCID: PMC8520423 DOI: 10.11604/pamj.2021.39.257.26201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 06/18/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction metabolic syndrome portends an increased risk of cardiovascular events and death. Evidence showed that healthcare workers are at higher risk of cardiovascular events because of their engagement in night-shift work. Therefore, this study determined the association between metabolic syndrome and healthcare work status in Ekiti State, Nigeria. Methods this was a cross-sectional study involving 105 healthcare workers and 143 non-healthcare workers. The diagnosis of metabolic syndrome was made based on the International Diabetic Federation criteria: abdominal obesity plus, any two of: elevated blood pressure ≥ 130/85 mmHg or previous diagnosis of hypertension on the use of antihypertensive medications; impaired fasting glucose; elevated triglycerides; and low HDL-cholesterol. Factors associated with metabolic syndrome were analysed using univariable and multivariable analysis. Results men comprised 37.9% of the study population and the mean age was 42.1 ± 9.7 years. The prevalence of metabolic syndrome was similar in both groups (HCWs-29.5% vs non-HCWs- 28.0%, p-value=0.789); overall prevalence was 28.6%. Abdominal obesity, elevated total cholesterol and elevated LDL-cholesterol occurred more frequently in HCWs than in non-HCWs: (68.6% vs 55.2%, p-value=0.034; 65.7% vs 39.2%, p-value= < 0.001 and 50.5 vs 28.7%; p-value < 0.001) respectively. Female sex (aOR: 3.67, 95% CI: 1.74-7.45; p < 0.001) and obesity (aOR: 4.39, 95% CI: 2.31-8.37; p < 0.001) were associated with metabolic syndrome. Conclusion a similar prevalence of metabolic syndrome was observed in the healthcare workers and the non- healthcare workers. However, abdominal obesity, elevated total cholesterol and elevated LDL-cholesterol occurred more frequently in healthcare workers than in non- healthcare workers.
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Affiliation(s)
- Bolade Folasade Dele-Ojo
- Department of Medicine, Ekiti State University, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Taiwo Hussean Raimi
- Department of Medicine, Ekiti State University, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Joseph Olusesan Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Samuel Ayokunle Dada
- Department of Medicine, Ekiti State University, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Ebenezer Adekunle Ajayi
- Department of Medicine, Ekiti State University, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - David Daisi Ajayi
- Department of Chemical Pathology, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | | | - Akande Oladimeji Ajayi
- Department of Medicine, Ekiti State University, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
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Magnitude of metabolic syndrome in Gondar town, Northwest Ethiopia: A community-based cross-sectional study. PLoS One 2021; 16:e0257306. [PMID: 34618823 PMCID: PMC8496848 DOI: 10.1371/journal.pone.0257306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 08/30/2021] [Indexed: 11/19/2022] Open
Abstract
Background Metabolic syndrome (MetS) is becoming a major public health problem globally; it is clear that the burden of MetS is rapidly increasing the rates of non-communicable diseases (NCD). In Ethiopia studies done so far have shown a large disparity in magnitude of the prevalence of MetS and were mainly institution-based studies. Therefore, this study assess the prevalence of MetS among adults who are residing in Gondar city using Adult Treatment Panel III (ATP III) and the International Diabetes Federation (IDF) assessment tool. The findings are imperative to developing and strengthening national NCD prevention and control programs. Methods This study was conducted in Gondar city Northwest Ethiopia in 2018. It employs a community-based cross-sectional study design among 3,227 individuals 18 years of age or older. Data was collected using the WHO stepwise tool, lipid profile, blood pressure (BP), waist circumference (WC) body mass index (BMI), fasting blood glucose levels (FG), and anthropometric measurements. The prevalence estimation was made along with a 95% confidence interval (CI). The Kappa statistic was used to analyze the statistical agreement between ATP III and IDF definitions of the MetS. Stratified analysis was also performed for description and analysis components using ATP III and IDF as an outcome. Result Of the total study participants (3227), 3059 (94.8%) were included in the final analysis and 52.5% were female. The mean (±SD) age of the study participant was 40.8 years (16.2 ±SD). The overall prevalence of MetS using ATP III was 11.2% [95%CI: 10.1, 12.3] and using IDF was 11.9% [95%CI: 10.8, 13.2]. The sex-specific proportion was high in females rather than males irrespective of the criteria. The overall level of agreement between ATP III and IDF prevalence was 91.7% and the Kappa statistics was 0.594. Older age, low-density lipoprotein cholesterol, body mass index, being female, born in an urban area, consumption of an alcoholic drink in the preceding 30 days, and non-fasting practice was significantly associated with MetS. Conclusion and recommendation There was a higher prevalence of metabolic syndrome among females than males irrespective of metabolic syndrome diagnostic criteria. This also shows good agreement between ATP III and IDF. Being female, urban birthplace, frequent alcohol consumption in the last 30 days, and non-fasting practice are factors associated with higher rates of metabolic syndrome. Hence, awareness campaigns, physical exercise, and nutrition education intervention should be undertaken to promote health behavioral practice.
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Epidemiology, risk factors, social determinants of health, and current management for non-alcoholic fatty liver disease in sub-Saharan Africa. Lancet Gastroenterol Hepatol 2021; 6:1036-1046. [PMID: 34508671 DOI: 10.1016/s2468-1253(21)00275-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 12/13/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease globally and is estimated to affect approximately 25% of the world's population. Data about the prevalence and incidence of NAFLD in Africa are scarce, but the prevalence is estimated to be 13·5% for the general population. This is likely to be an underestimate considering the increasing burden of non-communicable diseases, particularly the rising prevalence of obesity and type 2 diabetes, driven by the overlapping challenges of food insecurity, nutritional transition, and associated increased consumption of calorie-dense foods. Establishing the true prevalence of NAFLD, raising public awareness around the risk factors behind the increase in NAFLD, and proactively addressing all components of metabolic syndrome will be important to combat this silent epidemic, which will have long-term health-care costs and economic consequences for the region.
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Cissé K, Samadoulougou DRS, Bognini JD, Kangoye TD, Kirakoya-Samadoulougou F. Using the first nationwide survey on non-communicable disease risk factors and different definitions to evaluate the prevalence of metabolic syndrome in Burkina Faso. PLoS One 2021; 16:e0255575. [PMID: 34351987 PMCID: PMC8341491 DOI: 10.1371/journal.pone.0255575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 07/20/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The burden of cardiovascular diseases is rising in the developing world including Sub-Saharan Africa. The rapid rise of cardiovascular disease burden is in part due to undetected and uncontrolled cardiovascular risk factors. The clustering of metabolic syndrome (MetS) components is associated with a high risk of cardiovascular diseases. This complex biochemical disorder is still poorly studied in western Africa. In this study, we aimed to determine the prevalence of metabolic syndrome and its determinants among the adult population in Burkina Faso. METHODS We performed a secondary analysis of the data from the first national survey on non-communicable diseases risk factors using the World Health Organization (WHO) Stepwise approach. We included 4019 study participants aged 25 to 64 years. The metabolic syndrome prevalence was estimated using six different definitions. RESULTS The mean age was 38.6±11.1 years. Women represented 52.4% and three quarters (75%) lived in rural areas. The overall prevalence of metabolic syndrome according to the different definitions was 1.6% (95%CI:1.1-2.2) for the American College of Endocrinology, 1.8% (95%CI: 1.3-2.4) for the WHO, 4.3% (95%CI:3.5-5.2) for the National Cholesterol Education Program Adult Treatment Panel III, 6.2% (95%CI: 5.1-7.6) for the AAH/NHBI, 9.6%(95%CI: 8.1-11.3) for the International Diabetes Federation and 10.9% (95%: 9.2-12.7) for the Joint Interim Statement. The metabolic syndrome components with the highest prevalence were low High density lipoprotein (63.3%), abdominal obesity (22.3%) and hypertension (20.6%). People living in urban areas and those with older age have higher prevalence of metabolic syndrome regardless of the definition used. CONCLUSION Our findings suggest various levels of prevalence of MetS according to the definition used. Identifying the most appropriate criteria for MetS among the adult population is important to early detect and treat this syndrome and its components at the primary health care level to control the rising burden of cardiovascular diseases in the context of ongoing epidemiological transition in the country.
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Affiliation(s)
- Kadari Cissé
- Centre de Recherche en Epidémiologie, Biostatistiques et Recherche Clinique, Ecole de Santé Publique, Université libre de Bruxelles, Brussels, Belgium
- Departement Biomédical et Santé Publique, Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | | | - Joel Dofinissery Bognini
- Centre National de la Recherche Scientifique et Technologique, Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Tiga David Kangoye
- Institut national de santé publique (INSP), CNRFP, Ouagadougou, Burkina Faso
| | - Fati Kirakoya-Samadoulougou
- Centre de Recherche en Epidémiologie, Biostatistiques et Recherche Clinique, Ecole de Santé Publique, Université libre de Bruxelles, Brussels, Belgium
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The prevalence and related factors of metabolic syndrome in outpatients with first-episode drug-naive major depression comorbid with anxiety. Sci Rep 2021; 11:3324. [PMID: 33558554 PMCID: PMC7870819 DOI: 10.1038/s41598-021-81653-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/06/2021] [Indexed: 01/13/2023] Open
Abstract
Metabolic syndrome (MetS) is associated with depression, but its role in major depressive disorder comorbid with anxiety (AMD) is unclear. This study aimed to investigate the prevalence and clinical correlates of MetS in first-episode drug-naive (FEDN) patients with AMD in a Chinese Han population. In total, 1380 FEDN outpatients with AMD were recruited in this cross-sectional study. The sociodemographic features, clinical characteristics, history of suicide attempts, thyroid-stimulating hormone (TSH) levels, and MetS parameters of each subject were evaluated. All subjects were rated on the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), and the Positive and Negative Syndrome Scale positive symptom subscale. The prevalence of MetS among AMD patients was 8.04%. Compared to the non-MetS group, age, age of onset, TSH level, HAM-A and HAM-D scores, history of attempted suicide, and comorbid psychiatric symptoms were higher in the MetS group. Those in this group were also more likely to be married, and they had a lower educational level. Furthermore, age, psychiatric symptoms, suicide attempts, and higher TSH levels were independently associated with MetS in AMD patients. This study suggests a lower prevalence of MetS in FEDN patients with AMD in a Chinese Han population. Older age, comorbid psychiatric symptoms, history of attempted suicide, and higher TSH levels are related factors for MetS in AMD patients.
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Association between cardiometabolic health and objectively-measured, free-living sleep parameters: a pilot study in a rural African setting. SLEEP SCIENCE AND PRACTICE 2021. [DOI: 10.1186/s41606-020-00054-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Abstract
Objectives
To investigate the relationship between objectively-measured, free-living sleep quantity and quality, and cardiometabolic health, in a rural African setting in 139 adults (≥40 years, female: n = 99, male: n = 40). Wrist-mounted, tri-axial accelerometry data was collected over 9 days. Measures of sleep quantity and quality, and physical activity were extracted from valid minute-by-minute data. Self-reported data included behavioural, health and socio-demographic variables. Biological data included body composition, resting blood pressure and fasting blood glucose, insulin and lipids. Logistic regression models were constructed with insulin resistance (IR) and cardiometabolic (CM) risk, as dependent variables, adjusting for socio-demographic, behavioural and biological factors.
Results
Nocturnal sleep time was longer in females (p = 0.054) and sleep quality was better in males (p ≤ 0.017). Few participants slept > 9 h/night (4–5%), and 46–50% slept < 7 h/night. IR and CM risk was higher in females (p ≤ 0.006). In adjusted models, sleep variables were independently associated with IR (p < 0.05). Sleep quantity was non-linearly associated with CM risk (p ≤ 0.0398), and linearly associated with IR (p ≤ 0.0444). Sleep quality was linearly related with CM risk and IR (p ≤ 0.0201). In several models, sleep quantity and sleep quality measures were concurrently and significantly associated with IR (p ≤ 0.044).
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Fanta K, Daba FB, Asefa ET, Chelkeba L, Melaku T. Prevalence and Impact of Metabolic Syndrome on Short-Term Prognosis in Patients with Acute Coronary Syndrome: Prospective Cohort Study. Diabetes Metab Syndr Obes 2021; 14:3253-3262. [PMID: 34295168 PMCID: PMC8290164 DOI: 10.2147/dmso.s320203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 06/24/2021] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Despite the increasing burden of metabolic syndrome (MS) and ischemic heart disease in sub-Saharan Africa, data on the prevalence of MS among patients with acute coronary syndrome (ACS) from the regions are limited. Hence, this study is aimed to evaluate the prevalence and impact of MS on 30-day all-cause mortality in patients hospitalized with ACS. PATIENTS AND METHODS We prospectively assessed 176 ACS patients, who were admitted to two tertiary hospitals in Ethiopia. MS was diagnosed based on a harmonized definition of MS. In-hospital major adverse cardiovascular events (MACE) and 30-day mortality were recorded. Multivariable cox-regression was used to identify predictors of 30-day mortality. RESULTS Among 176 ACS patients enrolled, 62 (35.2%) had MS. Majority of the patients (62.5%) were male with the mean age of 56±11.9 years. ACS patients with MS were older, presented with atypical symptoms, and they had history of hypertension, diabetes, dyslipidemia and coronary artery disease compared to those without MS. MS was also significantly associated with in-hospital MACE (30.6% vs 17.5%; p= 0.046) and 30-day mortality [adjusted hazard ratio (AHR) = 3.25, 95% CI=1.72-6.15]. The other significant predictors of 30-day mortality were pre-hospital delay >12h (HR= 4.32, 95% CI=1.68-11.100), killip class ≥2 (HR=10.7, 95% CI= 2.54-44.95), and ejection fraction <40 (HR= 2.59 95% CI=1.39-4.84). CONCLUSION The prevalence of MS among patients with ACS in Ethiopia is high. MS was significantly associated with high in-hospital MACE and it was an independent predictor of 30-day mortality. Initiating appropriate strategies on MS prevention and timely diagnosis of MS components could decrease the burden of ACS and improve patient's outcome.
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Affiliation(s)
- Korinan Fanta
- Department of Clinical Pharmacy, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
- Correspondence: Korinan Fanta Department of Clinical Pharmacy, Institute of Health, Jimma University, P.O.Box: 378, Jimma, EthiopiaTel +251 911598485Fax +251 476617980 Email
| | - Fekede Bekele Daba
- Department of Clinical Pharmacy, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Elsah Tegene Asefa
- Department of Internal Medicine, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Legese Chelkeba
- Department of Pharmacology and Clinical Pharmacy, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tsegaye Melaku
- Department of Clinical Pharmacy, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
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Nowicki GJ, Ślusarska B, Naylor K, Prystupa A, Rudnicka-Drożak E, Halyuk U, Pokotylo P. The Relationship Between the Metabolic Syndrome and the Place of Residence in the Local Community on the Example of the Janów Lubelski District in Eastern Poland: A Population-Based Study. Diabetes Metab Syndr Obes 2021; 14:2041-2056. [PMID: 33986605 PMCID: PMC8110259 DOI: 10.2147/dmso.s301639] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/20/2021] [Indexed: 12/15/2022] Open
Abstract
PURPOSE The aim of this study was to estimate the incidence concerning metabolic syndrome (MetS) in a local community with a low socioeconomic status and a medium and high cardiovascular risk on the example of residents of Janów Lubelski district, eastern Poland. The second goal of the research was to analyze the relationship between residence and the occurrence of MetS. METHODS We conducted a cross-sectional study of 4040 people living in eastern Poland. A group of 3046 people with medium and high cardiovascular risk was selected among the respondents and included in further analyzes. The research adopted the definition criteria proposed by the National Cholesterol Education Program - Third Adult Treatment Panel (NCEP ATP III) to implement diagnostic evaluation of MetS. RESULTS It was observed that metabolic syndrome was significantly more frequent among the inhabitants of rural areas (40.56%; n=810) compared to those living in the city (35.27%; n=370) p=0.005. Among the inhabitants of rural areas, the percentage of people with elevated glucose levels was significantly higher, fasting blood glucose (FGB) p<0.001, elevated blood pressure (HBP) p<0.001, elevated serum triglycerides (TGs) p=0.01, and abnormal waist circumference (WC) p=0.003 compared to urban inhabitants. After adjusting for potential confounding variables (age, education, smoking, marital status, and level of physical activity), in both women and men, the odds of developing metabolic syndrome were approximately 30% higher in rural areas compared to urban residents (women: odds ratio (OR)=1.25, 95% confidence intervals (CI)=1.01-1.56; men: OR=1.30, 95% CI=1.01-1.67). CONCLUSION AND RECOMMENDATIONS A higher incidence of metabolic syndrome was observed among respondents living in rural areas than those living in cities. Similarly, across the gender strata, metabolic syndrome is more commonly diagnosed among men and women living in rural areas. Healthcare workers, especially in rural areas, should engage in education, prevention, and the promotion of a healthy lifestyle.
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Affiliation(s)
- Grzegorz Józef Nowicki
- Department of Family Medicine and Community Nursing, Medical University of Lublin, Lublin, Poland
- Correspondence: Grzegorz Józef Nowicki Department of Family Medicine and Community Nursing, Medical University of Lublin, Staszica 6 Street, PL-20-081, Lublin, PolandTel +48 81448 6810Fax +48 81448 6811 Email
| | - Barbara Ślusarska
- Department of Family Medicine and Community Nursing, Medical University of Lublin, Lublin, Poland
| | - Katarzyna Naylor
- Department of Didactics and Medical Simulation, Medical University of Lublin, Lublin, Poland
| | - Andrzej Prystupa
- Department of Internal Medicine, Medical University of Lublin, Lublin, Poland
| | | | - Ulyana Halyuk
- Department of Normal Anatomy, Lviv National Medical University, Lviv, Ukraine
| | - Petro Pokotylo
- Department of Normal Anatomy, Lviv National Medical University, Lviv, Ukraine
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Amponsah-Dacosta E, Tchuem CT, Anderson M. Chronic hepatitis B-associated liver disease in the context of human immunodeficiency virus co-infection and underlying metabolic syndrome. World J Virol 2020; 9:54-66. [PMID: 33362998 PMCID: PMC7747023 DOI: 10.5501/wjv.v9.i5.54] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/24/2020] [Accepted: 10/12/2020] [Indexed: 02/06/2023] Open
Abstract
Globally, a shift in the epidemiology of chronic liver disease has been observed. This has been mainly driven by a marked decline in the prevalence of chronic hepatitis B virus infection (CHB), with the greatest burden restricted to the Western Pacific and sub-Saharan African regions. Amidst this is a growing burden of metabolic syndrome (MetS) worldwide. A disproportionate co-burden of human immunodeficiency virus (HIV) infection is also reported in sub-Saharan Africa, which poses a further risk of liver-related morbidity and mortality in the region. We reviewed the existing evidence base to improve current understanding of the effect of underlying MetS on the development and progression of chronic liver disease during CHB and HIV co-infection. While the mechanistic association between CHB and MetS remains poorly resolved, the evidence suggests that MetS may have an additive effect on the liver damage caused by CHB. Among HIV infected individuals, MetS-associated liver disease is emerging as an important cause of non-AIDS related morbidity and mortality despite antiretroviral therapy (ART). It is plausible that underlying MetS may lead to adverse outcomes among those with concomitant CHB and HIV co-infection. However, this remains to be explored through rigorous longitudinal studies, especially in sub-Saharan Africa. Ultimately, there is a need for a comprehensive package of care that integrates ART programs with routine screening for MetS and promotion of lifestyle modification to ensure an improved quality of life among CHB and HIV co-infected individuals.
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Affiliation(s)
- Edina Amponsah-Dacosta
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, Western Cape, South Africa
| | - Cynthia Tamandjou Tchuem
- Health Economics Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, Western Cape, South Africa
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Shiferaw WS, Akalu TY, Gedefaw M, Anthony D, Kassie AM, Misganaw Kebede W, Mulugeta H, Dessie G, Aynalem YA. Metabolic syndrome among type 2 diabetic patients in Sub-Saharan African countries: A systematic review and meta-analysis. Diabetes Metab Syndr 2020; 14:1403-1411. [PMID: 32755843 DOI: 10.1016/j.dsx.2020.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS Metabolic syndrome is one of the serious public health problems among type 2 diabetic patients. Despite a number of studies have been conducted, there is no overall estimation on the prevalence of metabolic syndrome among type 2 diabetic patients in Sub-Saharan African countries. Therefore, this study aimed to estimate the pooled prevalence of metabolic syndrome in patients with type 2 diabetes mellitus in Sub -Saharan African countries. METHODS PubMed, Web of Science, African Journals Online, Google Scholar, Scopus, and Wiley Online Library databases from inception to April 27, 2020 were searched to identify relevant studies. The I2 statistic was used to check heterogeneity across the included studies. DerSimonian and Laird random-effects model was applied to estimate pooled effect size, and 95% confidence interval across studies. A funnel plot and Egger's regression test were used to determine the presence of publication bias. Sensitivity analysis was deployed to determine the effect of a single study on the overall estimation. All statistical analyses were done using STATA™ Version 14 software. RESULT In this meta-analysis, a total of 23 studies with 6482 study participants were included. The estimated prevalence of metabolic syndrome in Sub-Saharan African countries was 59.62% (95% CI: 52.20, 67.03). Based on the subgroup analysis, the highest prevalence of metabolic syndrome (61.14%, 95% CI: 51.74, 70.53) was reported in Ethiopia. Additionally, the highest prevalence of metabolic syndrome was reported across studies using the diagnostic criteria of National Cholesterol Education Program Adult Treatment Panel III 64.8% (95% CI: 54.74, 74.86), followed by International Diabetic Federation (57.15%), and World health Organization (53.12%) definitions. CONCLUSION Almost two out of three type 2 diabetic patients in Sub-Saharan African countries have metabolic syndrome, which implies that its prevalence is high in patients with type 2 diabetes mellitus. Therefore, policymakers need to design efficient strategies and guideline to reduce and control the burden of metabolic syndrome and its impact among diabetic population.
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Affiliation(s)
- Wondimeneh Shibabaw Shiferaw
- Department of Nursing, College of Health Science, Institute of Medicine and Health Science, Debre Berhan University, Ethiopia.
| | - Tadesse Yirga Akalu
- Department of Nursing, College of Health Science, Debre Markos University, Ethiopia
| | - Mihretie Gedefaw
- Department of Nursing, College of Health Science, Debre Markos University, Ethiopia
| | - Denis Anthony
- Health and Social Care Research Centre, University of Derby and Emeritus Professor, School of Healthcare, University of Leeds, UK
| | | | - Worku Misganaw Kebede
- Department of Nursing, College of Health Science, Institute of Medicine and Health Science, Debre Berhan University, Ethiopia
| | - Henok Mulugeta
- Department of Nursing, College of Health Science, Debre Markos University, Ethiopia
| | - Getenet Dessie
- Department of Nursing, School of Health Science, College of Medicine and Health Science, Bahir Dar University, Ethiopia
| | - Yared Asmare Aynalem
- Department of Nursing, College of Health Science, Institute of Medicine and Health Science, Debre Berhan University, Ethiopia
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Su Y, Lu Y, Li W, Xue M, Chen C, Haireti M, Li Y, Liu Z, Liu Y, Wang S, Yao H. Prevalence and Correlation of Metabolic Syndrome: A Cross-Sectional Study of Nearly 10 Million Multi-Ethnic Chinese Adults. Diabetes Metab Syndr Obes 2020; 13:4869-4883. [PMID: 33335411 PMCID: PMC7737555 DOI: 10.2147/dmso.s278346] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/05/2020] [Indexed: 12/26/2022] Open
Abstract
PURPOSE This study aimed to examine the prevalence and correlates of metabolic syndrome (MetS) in multi-ethnic populations of Northwest China based on Large-scale provincial health checking data. PATIENTS AND METHODS A total of 9,745,640 Chinese aged ≥18 years in Xinjiang, the largest autonomous region of multi-ethnic in China, were enrolled from Feb. to Sep. 2019. MetS was defined by modified Adult Treatment Panel (ATP III) criteria. RESULTS The overall prevalence of MetS was 20.85% [Sex: 20.06% female, 21.56% male; Age: 39.22% 60-years and above, 26.32% 40- to 59-years and 9.56% 18- to 39-years; Ethnicity: 28.19% Hui followed by Han (26.39%), Uyghur (18.56%), Other (18.61%), Kazak (17.98%), Mongolian (17.87%), Kyrgyz (14.44%)]. People living in cities and towns (23.03%) or North (24.78%) had higher prevalence of MetS than rural (19.94%) and South (17.66%). Although the prevalence of hypertension, smoking, drinking and lack of physical activity were higher in Kyrgyz, Mongolian and Kazak than those of other ethnic groups, the risk of MetS was lower. CONCLUSION The results indicated that a high prevalence of MetS in Hui and Han groups and people living in cities and towns. Living in North Xinjiang and elder population tend to have higher prevalence of MetS. The prevention and management of MetS in these populations should be prioritized.
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Affiliation(s)
- Yinxia Su
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- Health Management Institute, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Yaoqin Lu
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- Center of Disease Control and Prevention, Urumqi, Xinjiang, People’s Republic of China
| | - Wenli Li
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Mingyue Xue
- Health Management Institute, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- The Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Chen Chen
- School of Biomedical Sciences, University of Queensland, Brisbane4072, Australia
| | - Muyaseer Haireti
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Yuanyuan Li
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Zhenhui Liu
- Department of Microrepair and Reconstruction, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Yanshi Liu
- Department of Microrepair and Reconstruction, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Shuxia Wang
- Health Management Institute, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Hua Yao
- Health Management Institute, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- Correspondence: Hua Yao; Shuxia Wang Email ;
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Mengesha MM, Ayele BH, Beyene AS, Roba HS. Clustering of Elevated Blood Pressure, Elevated Blood Glucose, and Abdominal Obesity Among Adults in Dire Dawa: A Community-Based Cross-Sectional Study. Diabetes Metab Syndr Obes 2020; 13:2013-2024. [PMID: 32606860 PMCID: PMC7305819 DOI: 10.2147/dmso.s250594] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/28/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Evidence shows that the presence of a single component of the metabolic syndrome (MetS) increases the risk of developing the MetS later in life. This study estimated the prevalence and associated factors of abdominal obesity, elevated blood pressure, elevated blood glucose, and the 3-factor MetS components among urban adults in Dire Dawa, East Ethiopia. METHODS Community-based cross-sectional data were collected from 872 adults aged 25-64 years. The joint interim statement (JIS) was used to define the MetS components. The dependent outcome variables were both the individual and the 3-factor MetS components. A robust variance Poisson regression model was used to directly estimate the prevalence ratio (PR) of risk factors. RESULTS The prevalence of the 3-factor MetS components (abdominal obesity, elevated blood pressure, and elevated blood glucose) was 9.5% (95% CI: 7.7, 11.7). Women had two times higher prevalence of the 3-factor MetS components compared with men, 11.6% (95% CI: 9.2, 14.5) vs 5.2% (95% CI: 3.2, 8.5). A higher prevalence of abdominal obesity, 46.4% (95% CI: 43.1, 49.8), followed by a raised blood pressure, 42.7% (95% CI: 39.4, 46.0), was observed among study subjects. The presence of a single MetS component had an associated cluster of other components: 33.7% of subjects with elevated blood glucose, 22.3% with elevated blood pressure, and 20.5% with abdominal obesity had also the 3-factor MetS components. Age, sex, body mass index, waist circumference, and physical activity were significantly associated with the individual components or the 3-factor MetS components. CONCLUSION A higher prevalence of the individual components and the presence of clustering with a single factor identified call for the need of community screening. Interventions targeting both abdominal and general obesity through physical activity and lifestyle modification can contribute towards reducing cardiometabolic risk factors with due attention given to women and older adults.
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Affiliation(s)
- Melkamu Merid Mengesha
- Haramaya University, College of Health and Medical Sciences, School of Public Health, Department of Epidemiology and Biostatistics, Harar, Ethiopia
- Correspondence: Melkamu Merid Mengesha College of Health and Medical Sciences, Harar, EthiopiaTel +251912094941 Email
| | - Behailu Hawulte Ayele
- Haramaya University, College of Health and Medical Sciences, School of Public Health, Department of Public Health and Health Policy, Harar, Ethiopia
| | - Addisu Shunu Beyene
- Haramaya University, College of Health and Medical Sciences, Department of Environmental Health Sciences, Harar, Ethiopia
| | - Hirbo Shore Roba
- Haramaya University, College of Health and Medical Sciences, School of Public Health, Department of Epidemiology and Biostatistics, Harar, Ethiopia
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