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Azagew AW, Abate HK, Mekonnen CK, Mekonnen HS, Tezera ZB, Jember G. Diabetic dyslipidemia and its predictors among people with diabetes in Ethiopia: systematic review and meta-analysis. Syst Rev 2024; 13:190. [PMID: 39033198 PMCID: PMC11264949 DOI: 10.1186/s13643-024-02593-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 06/20/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Dyslipidemia is an imbalance of lipid profiles. It increases the chance of clogged arteries and may cause heart attacks, strokes, and other circulatory disorders. Dyslipidemia affects the general population, but its severity is higher in diabetic populations. As a result, the chance of dyslipidemia-associated morbidity and mortality is highest in diabetic patients. In Ethiopia, around 2 to 6.5% of the population live with diabetes, but their lipid profiles are inconsistent across the studies. Therefore, this study aimed to estimate the pooled prevalence of diabetic dyslipidemia and its predictors among people with diabetes in Ethiopia. METHOD A systematic review and meta-analysis was conducted. The searches were carried out in MEDLINE via PubMed and OVID, EBSCO, Embase, and other supplementary gateways such as Google and Google Scholar, for articles published up to June 2023. The articles were searched and screened by title (ti), abstract (ab), and full text (ft). The quality of the eligible studies was assessed by the Newcastle-Ottawa scale. The heterogeneity was detected by the Cochrane Q statistic test and the I-squared (I2) test. Then subgroup analysis and meta-regression analysis were used to identify the source of the variations. A random or fixed-effect meta-analysis model was used to estimate the overall pooled prevalence and average effects. The publication bias was assessed by the funnel plot asymmetry test and/or Begg and Mazumdar's test for rank correlation (p-value < 0.05). The protocol has been registered in an international database, the prospective register of systematic reviews (PROSPERO), with reference number CRD42023441572. RESULT A total of 14 articles with 3662 participants were included in this review. The pooled prevalence of diabetic dyslipidemia in Ethiopia was found to be 65.7% (95% confidence interval (CI): 57.5, 73.9), I2 = 97%, and p-value < 0.001. The overall prevalence of triglycerides (TG) and high-density lipoprotein cholesterol (HDL-c) were found to be 51.8% (95% CI: 45.1, 58.6) and 44.2% (95% CI: 32.8, 55.7), respectively, among lipid profiles. In meta-regression analysis, the sample size (p value = 0.01) is the covariate for the variation of the included studies. Being female (adjusted odds ratio (AOR): 3.9, 95% CI: 1.5, 10.1), physical inactivity (AOR: 2.6, 95% CI: 1.5, 4.3), and uncontrolled blood glucose (AOR: 4.2, 95% CI: 1.9, 9.4) were found to be the determinants of dyslipidemia among diabetic patients. CONCLUSION This review revealed that the prevalence of diabetic dyslipidemia is high among people with diabetes in Ethiopia. Being female, having physical inactivity, and having uncontrolled blood glucose were found to be predictors of dyslipidemia among people with diabetes. Therefore, regular screening of lipid profiles and the provision of lipid-lowering agents should be strengthened to reduce life-threatening cardiovascular complications. Furthermore, interventions based on lifestyle modifications, such as regular physical activity and adequate blood glucose control, need to be encouraged.
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Affiliation(s)
- Abere Woretaw Azagew
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Hailemichael Kindie Abate
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Chilot Kassa Mekonnen
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habtamu Sewunet Mekonnen
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zewdu Baye Tezera
- Department of Comprehensive Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Jember
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Ekpor E, Addo-Mensah D, Akyirem S. Prevalence of dyslipidemia among persons with type 2 diabetes in Africa: a systematic review and meta-analysis. Ann Med Surg (Lond) 2024; 86:3468-3477. [PMID: 38846843 PMCID: PMC11152840 DOI: 10.1097/ms9.0000000000002122] [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: 03/12/2024] [Accepted: 04/20/2024] [Indexed: 06/09/2024] Open
Abstract
Background Dyslipidemia is an established cardiovascular risk factor in persons with type 2 diabetes (T2D), yet the extent to which these conditions co-occur in Africa is unknown. This systematic review and meta-analysis aimed to determine the prevalence of dyslipidemia among persons with T2D in Africa. Methods Medline, Embase, Global Health, Scopus, and Web of Science were searched on 5 December 2023. This review adhered to the PRISMA guidelines and was prospectively registered on PROSPERO. The prevalence data for dyslipidemia was pooled through a random-effects meta-analysis. The authors assessed heterogeneity and publication bias using I 2 statistics and Egger's test, respectively. Results Our search identified 8035 records, of which 60 articles involving 20 034 individuals with T2D were included in this review. The pooled prevalence of dyslipidemia recorded 38.6% (95% CI: 34.1-43.4) for high TC (≥ 5.2 mmol/l), 52.7% (95% CI: 44.2-61.1) for high low-density lipoprotein cholesterol (LDL-C) (≥ 2.6 mmol/l), 43.5% (95% CI: 37.1-50.0) for low high-density lipoprotein cholesterol (HDL-C) (< 1.0 mmol/l in men and less than 1.3 mmol/l in women), and 37.4% (95% CI: 32.2-42.9) for high triglycerides (TG) (≥ 1.7 mmol/l). Subgroup analysis based on gender indicated a notably higher prevalence of dyslipidemia among females compared to males. Conclusion Dyslipidemia is prevalent among persons with T2D in Africa. This highlights the need for early screening, diagnosis, and management of dyslipidemia to mitigate the risk of cardiovascular complications in this population.
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Affiliation(s)
- Emmanuel Ekpor
- School of Nursing and Midwifery, University of Ghana, Legon
- Christian Health Association of Ghana, Accra, Ghana
| | - Dorothy Addo-Mensah
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC
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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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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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Sharma K, Poudyal S, Subba HK, Khatiwada S. Metabolic syndrome and life style factors among diabetes patients attending in a teaching hospital, Chitwan. PLoS One 2023; 18:e0286139. [PMID: 37228052 DOI: 10.1371/journal.pone.0286139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 05/10/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is associated with an increased incidence of chronic complications and mortality of diabetes patients. Prevention and treatment of MetS is important means of lowering the risk of cardiovascular diseases and mortality. OBJECTIVE This study aimed to find out metabolic syndrome and life style factors among diabetes patients. METHODS A cross-sectional survey was carried out among 296 patients with type 2 diabetes mellitus attending Chitwan Medical College Teaching Hospital. Consecutive sampling technique was used to select sample. Data were collected from 15th December 2021 to 15th March, 2022 using Interview Schedule, bio-physiological measurement and record review. Obtained data were analysed in SPSS version 20 for window using descriptive and inferential statistics. Chi-square test was applied to measure the association between the variables. Logistic regression analysis was performed to identify the factors associated with metabolic syndrome. RESULT Findings revealed that the prevalence of MetS was 66.2% and 58.4% in patients according to International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria respectively. The most common MetS parameters were raised fasting plasma glucose (94.6%) and abnormal waist circumference (78.4% in IDF criteria) while the least prevalent parameter was reduced HDL level (43.2%). Majorities of the patients were non-vegetarian (85.5%), had poor dietary compliance (poor-46.3%, very poor-32.1%), overweight/obese (65.5%), and suffered from moderate stress (90.1%). Bivariate analysis showed that MetS as per NCEP ATP criteria was significantly associated with gender (p = 0.006), occupation (p = 0.007), presence of other co-morbid condition (<0.001) and sleep problem (p = <0.001). However, MetS as per IDF criteria was significantly associated with age (p = <0.028), duration of diabetes (p = <0.001), follow-up visit (p = <0.030), blood sugar monitoring (p = <0.009) and physical activity of diabetes patients (p = <0.001). Further logistic regression analysis revealed that sleep problem (AOR = 21.812;95%CI = 8.512,55.894) and presence of other comorbidities (AOR = 4.024;95%CI = 2.220,7.295) were the significant factors of metabolic syndrome. CONCLUSION AND RECOMMENDATION Metabolic syndrome is high in patients with type 2 diabetes mellitus. Therefore, treating physicians and other health workers need to monitor MetS parameters regularly to reduce the risk of cardiovascular diseases, stroke and premature death.
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Affiliation(s)
- Kalpana Sharma
- School of Nursing, Chitwan Medical College, Bharatpur, Nepal
| | - Sunita Poudyal
- School of Nursing, Chitwan Medical College, Bharatpur, Nepal
| | - Hem K Subba
- School of Nursing, Chitwan Medical College, Bharatpur, Nepal
| | - Saurav Khatiwada
- Departments of Endocrine Medicine, Chitwan Medical College, Bharatpur, Nepal
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Zawdie B, Tesfaye T, Moges SB, Tesfaye Y, Kebede A, Tadesse M, Gudina EK, Dadi LS, Tamiru D, Lemma TB. Metabolic syndrome distributions in dietary diversity score groups and its associated factors among adults in the urban community of Jimma, Southwest Ethiopia: a community based cross- sectional study. BMC Endocr Disord 2022; 22:328. [PMID: 36544146 PMCID: PMC9773519 DOI: 10.1186/s12902-022-01238-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Dietary diversity score has long been recognized as a key component of diets quality balances for healthy life status. However, diets with more variety of food items might increase calorie intake and body weight, which, in turn leads to central obesity (waist circumference).Therefore, this study aims to determine the prevalence of metabolic syndrome among dietary diversity score groups, and its associated factors among adults in the urban community of Jimma, Southwest Ethiopia. METHODS A total of 915 adults aged ≥ 18 years were randomly recruited in this cross-sectional study.The study was undertaken from June 17, 2019, up to July 27, 2019. To this end, the collected data were entered to Epi Data 3.1 and analysed using and SPSS 25 version. What's more, a multivariable logistic regression was used to assess associated factors of the unrecognized metabolic syndrome; adjusted odds ratio (AOR) with its corresponding 95% CI, at P-value ≤ 0.05. RESULTS The occurrence of metabolic syndrome was 14.4%, and it is more prevalent in females, 11.15% than males, and 3.25%. The most prevalent components of the metabolic syndrome were low level of high-density lipoprotein, elevated level of triacylglycerol, and waist circumferences. Even though metabolic syndrome is not significantly associated with any of the dietary diversity score groups, its prevalence distribution varies among the groups (6.6% in middle, 5.8% in high and 1.9% in low dietary diversity groups). With potential confounders adjusted, by 75% female was significantly associated with the occurrence of metabolic syndrome than male (102 vs. 29, AOR = 0.25 at 95%CI: 0.15-0.40, P = 0.001). Whereas, age ≥ 35 years old (104 vs. 27, AOR = 2.91 at 95%CI:1.78-4.86,P = 0.001), large family size > 5 (65 vs. 10,AOR = 2.43 95% CI: 1.10-5.36, P = 0.03), overweight and obesity (121 vs. 10, AOR = 6.97, 95% CI: 4.50 -10.83, P = 0.005), elevated total cholesterol (103 vs. 28,AOR = 2.46, 95% CI: 1.47-4.11, P = 0.001), and consuming ( spices, condemns and beverages) ≥ 4 days per week (79 vs. 52, AOR = 0.52, 95% CI:0.33 -0.82, P = 0.005) were positively associated with the prevalence of metabolic syndrome as compared to their counterparts. CONCLUSION Unrecognized metabolic syndrome was relatively high in the study community. The prevalence of metabolic syndrome varied among dietary diversity groups. But any of the dietary diversity scoring categories was not significantly associated with the occurrence of metabolic syndrome. Thus, awareness needs to be made to practice healthy diet and regular physical activity to maintaining normal body weight. Moreover, early screening of metabolic syndrome should be promoted.
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Affiliation(s)
- Belay Zawdie
- Department of Biomedical Sciences, Jimma University, Jimma, Ethiopia
| | - Temamen Tesfaye
- School of Nursing and Midwifery, Jimma University, Jimma, Ethiopia
| | | | - Yonas Tesfaye
- Department of Psychiatry, Jimma University, Jimma, Ethiopia
| | - Ayantu Kebede
- Departments of Epidemiology, Jimma University, Jimma, Ethiopia
| | - Mulualem Tadesse
- Department of Medical Laboratory, Jimma University, Jimma, Ethiopia
| | | | | | - Dessalegn Tamiru
- Department Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
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Belayneh M, Mekonnen TC, Tadesse SE, Amsalu ET, Tadese F. Sleeping duration, physical activity, alcohol drinking and other risk factors as potential attributes of metabolic syndrome in adults in Ethiopia: A hospital-based cross-sectional study. PLoS One 2022; 17:e0271962. [PMID: 36037175 PMCID: PMC9423638 DOI: 10.1371/journal.pone.0271962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 07/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Available evidence showed that metabolic syndrome in the adult population is persistently elevated due to nutrition transition, genetic predisposition, individual-related lifestyle factors, and other environmental risks. However, in developing nations, the burden and scientific evidence on the pattern, and risk exposures for the development of the metabolic syndrome were not adequately investigated. Thus, the study aimed to measure the prevalence of metabolic syndrome and to identify specific risk factors among adult populations who visited Dessie Comprehensive Specialized Hospital, Ethiopia. Methods A hospital-based cross-sectional study was conducted among randomly selected 419 adults attending Dessie Comprehensive Specialized Hospital from January 25 to February 29, 2020. We used the WHO STEP-wise approach for non-communicable disease surveillance to assess participants’ disease condition. Metabolic syndrome was measured using the harmonized criteria recommended by the International Diabetes Federation Task Force in 2009. Data were explored for missing values, outliers and multicollinearity before presenting the summary statistics and regression results. Multivariable logistic regression was used to disentangle statistically significant predictors of metabolic syndrome expressed using an odds ratio with a 95% of uncertainty interval. All statistical tests were managed using SPSS version 26. A non-linear dose-response analysis was performed to show the relationships between metabolic syndromes with potential risk factors. Results The overall prevalence of metabolic syndrome among adults was 35.0% (95% CI, (30.5, 39.8)). Women were more affected than men (i.e. 40.3% vs 29.4%). After adjusting for other variables, being female [OR = 1.85; 95% CI (1.01, 3.38)], urban residence [OR = 1.94; 95% CI (1.08, 3.24)], increased age [OR = 18.23; 95% CI (6.66, 49.84)], shorter sleeping durations [OR = 4.62; 95% CI (1.02, 20.98)], sedentary behaviour [OR = 4.05; 95% CI (1.80, 9.11)], obesity [OR = 3.14; 95% CI (1.20, 8.18)] and alcohol drinking [OR = 2.85; 95% CI (1.27,6.39)] were positively associated with the adult metabolic syndrome. Whilst have no formal education [OR = 0.30; 95% CI (0.12, 0.74)] was negatively associated with metabolic syndrome. Conclusions The prevalence of adult metabolic syndrome is found to be high. Metabolic syndrome has linear relationships with BMI, physical activity, sleep duration, and level of education. The demographic and behavioural factors are strongly related with the risk of metabolic syndrome. Since most of the factors are modifiable, there should be urgent large-scale community intervention programs focusing on increased physical activity, healthy sleep, weight management, minimize behavioural risk factors, and healthier food interventions targeting a lifecycle approach. The existing policy should be evaluated whether due attention has given to prevention strategies of NCDs.
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Affiliation(s)
- Mulugeta Belayneh
- Public Health Specialist at Dessie Comprehensive Specialized Hospital, Dessie, North Eastern Ethiopia
| | - Tefera Chane Mekonnen
- Academician and Researcher at School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
- * E-mail:
| | - Sisay Eshete Tadesse
- Academician and Researcher at School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Erkihun Tadesse Amsalu
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Fentaw Tadese
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Gebreyesus HA, Abreha GF, Besherae SD, Abera MA, Weldegerima AH, Gidey AH, Bezabih AM, Lemma TB, Nigatu TG. High atherogenic risk concomitant with elevated HbA1c among persons with type 2 diabetes mellitus in North Ethiopia. PLoS One 2022; 17:e0262610. [PMID: 35104300 PMCID: PMC8806058 DOI: 10.1371/journal.pone.0262610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 12/29/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a chronic disease associated with worse clinical presentation. However, the current investigation practices in Ethiopia have limitations to demonstrate the scope of the clinical burden. Hence, this study was aimed at assessing the glycemic status and coronary heart disease (CHD) risk of persons with T2DM using HbA1c and atherogenic index of plasma (AIP). METHOD This institution-based cross-sectional study was conducted among 421 adults with T2DM from September to November 2019. Demographic, socioeconomic, and lifestyle data were collected through a face-to-face interview. Clinical information was retrieved from medical records whereas anthropometric and biochemical measurements were performed using the WHO protocols. Glycemic status was determined using HbA1c and CHD risk assessed using an atherogenic index of plasma (AIP). Gaussian variables were expressed using mean and standard deviation (SD), Log-normal variables using geometric mean and 95% CI and non- Gaussian variables using median and interquartile ranges. Categorical variables were summarized using absolute frequencies and percentages. Multivariable logistic regression was used to identify factors associated with glycemic control with a statistical significance set at 5%. RESULT A total of 195 male and 226 female subjects were involved in this study. The results demonstrated that 77% (324) had HbA1c value ≥7% and 87.2% (367) had high atherogenic risk for CHD. Besides, 57% and 67.9% of persons with T2DM had metabolic syndrome according to International Diabetes Federation (IDF) and the National Cholesterol Education Program-Adult treatment panel III (NCEP-ATP III) criteria, respectively. About 36.8% had one or more comorbidities. Having healthy eating behavior [AOR 1.95; CI 1.11-3.43] and taking metformin [AOR 4.88; CI 1.91-12.44] were associated with better glycemic outcomes. CONCLUSION High AIP level concomitant with poor glycemic control indicates increased risk for coronary heart disease among persons with T2DM in Northern Ethiopia.
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Affiliation(s)
- Hagos Amare Gebreyesus
- Department of Nutrition & Dietetics, Jimma University, Jimma, Ethiopia
- College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | | | | | | | | | | | | | | | - Tsinuel Girma Nigatu
- Department of pediatrics and child health, Jimma University, Jimma, Ethiopia
- Jimma University Clinical and Nutrition Research Center (JUCAN), Jimma University, Jimma, Ethiopia
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Tegegne KD, Wagaw GB, Gebeyehu NA, Yirdaw LT, Shewangashaw NE, Mekonen NA, Kassaw MW. Prevalence of central obesity and associated factors in Ethiopia: A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2022; 13:983180. [PMID: 36111291 PMCID: PMC9468774 DOI: 10.3389/fendo.2022.983180] [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: 06/30/2022] [Accepted: 08/12/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Obesity is a global public health concern that is now on the rise, especially in low- and middle-income nations. Despite the fact that there are several studies reporting the prevalence of central obesity among adults in Ethiopia, there is a lack of a systematic review and meta-analysis synthesizing the existing observational studies. Therefore, this systematic review and meta-analysis aimed to determine the prevalence of central obesity and its associated factors in Ethiopia. METHODS Online libraries such as PubMed, Google Scholar, Scopus, Science Direct, and Addis Ababa University were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 16). Forest plots, Begg's rank test, and Egger's regression test were all used to check for publication bias. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by region and study setting. In addition, the pooled odds ratio for related covariates was calculated. RESULTS Out of 685 studies assessed, 20 met our criteria and were included in the study. A total of 12,603 people were included in the study. The prevalence of central obesity was estimated to be 37.31% [95% confidence interval (CI): 29.55-45.07]. According to subgroup analysis by study region and setting, the highest prevalence was observed in the Dire Dawa region (61.27%) and community-based studies (41.83%), respectively. Being a woman (AOR = 6.93; 95% CI: 3.02-10.85), having better socioeconomic class (AOR = 5.45; 95% CI: 0.56-10.34), being of age 55 and above (AOR = 5.23; 95% CI: 2.37-8.09), being physically inactive (AOR = 1.80; 95% CI: 1.37-2.24), being overweight (AOR = 4.00; 95% CI: 2.58-5.41), being obese (AOR = 6.82; 95% CI: 2.21-11.43), and having hypertension (AOR = 3.84; 95% CI: 1.29-6.40) were the factors associated with central obesity. CONCLUSION The prevalence of central obesity was high in Ethiopia. Being a woman, having a higher socioeconomic class, being older, being physically inactive, being overweight or obese, and having hypertension were all associated. Therefore, it is vital for the government and health organizations to design and implement preventive measures like early detection, close monitoring, and positive reversal of central obesity in all patients and the general population. High-quality investigations on the prevalence of central obesity in the Ethiopian people are required to better understand the status of central obesity in Ethiopia. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42022329234.
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Affiliation(s)
- Kirubel Dagnaw Tegegne
- Department of Comprehensive Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
- *Correspondence: Kirubel Dagnaw Tegegne,
| | - Gebeyaw Biset Wagaw
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Natnael Atnafu Gebeyehu
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
| | - Lehulu Tilahun Yirdaw
- Department of Emergency Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | | | - Nigusie Abebaw Mekonen
- Department of Midwifery, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Mesfin Wudu Kassaw
- School of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
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11
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Jemere T, Kefale B. Metabolic syndrome and its associated factors in Ethiopia: A systematic review and meta-analysis. J Diabetes Metab Disord 2021; 20:1021-1031. [PMID: 34222097 PMCID: PMC8212201 DOI: 10.1007/s40200-021-00815-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 05/02/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Metabolic syndrome (MetS) is a common complex entity that has emerged as a worldwide epidemic and major public health concern. The incidence of MetS often parallels the incidence of obesity and it is even worst among people living with comorbidities like; HIV/AIDS, hypertension, and mental illness. Therefore, there was an urgent need to summarize the extent and risk factors of MetS in Ethiopia. METHODOLOGY This systematic review was conducted according to the PRISMA guideline to investigate the prevalence of MetS and contributing factors. English language-based databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Cochrane library) were exhaustively searched to identify studies related to the prevalence of MetS. A random-effects model was employed to estimate the pooled prevalence of MetS, and it was computed using STATA 16.0 software. Heterogeneity analysis was reported using I2. RESULT A total of 25 studies with 21,431 study participants were included for this systematic review and meta-analysis. The pooled prevalence of MetS was 30.0% (95% CI: 24.0-36.0%, I2 = 99.19%, p < 0.001) with a high degree of heterogeneity across studies. Subgroup analysis with the target population showed that metabolic syndrome was most prevalent among type II diabetic 56% (95% CI: 47 - 64) and hypertensive patients 44% (95% CI: 35 - 53). Increased age, female gender, being overweight and obese, having a high educational level and income, physical inactivity, and being on treatment of chronic diseases like, diabetes mellitus, hypertension and HIV/AIDS were the most frequently reported risk factors of MetS regardless of the study population. CONCLUSION The prevalence of the MetS is high and rising in Ethiopia. Therefore, the preventative strategy should be considered to reduce the risk of morbidity or mortality related to metabolic syndrome.
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Affiliation(s)
- Tadeg Jemere
- Physiology Unit and Research Team, Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, PO Box 272, Debre Tabor, Amhara, Ethiopia
| | - Belayneh Kefale
- Clinical Pharmacy Unit and Research Team, Department of Pharmacy, College of Health Sciences, Debre Tabor University, PO Box 272, Debre Tabor, Amhara, Ethiopia
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Hypertriglyceridemia and Other Plasma Lipid Profile Abnormalities among People Living with Diabetes Mellitus in Ethiopia: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2021; 2021:7389076. [PMID: 34056001 PMCID: PMC8131138 DOI: 10.1155/2021/7389076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 03/11/2021] [Accepted: 04/30/2021] [Indexed: 11/17/2022]
Abstract
Background Dyslipidemia is one of the leading causes of cardiovascular complications in diabetes mellitus (DM) patients. Though it is a major public health problem in Ethiopia, there is no a nation-wide study to determine dyslipidemia among DM patients yet. Therefore, this systematic review and meta-analysis intended to estimate the prevalence of hypertriglyceridemia and other plasma lipid abnormalities among people living with DM in Ethiopia. Methods We systematically searched PubMed, Google Scholar, African Journals Online, Hinari, and direct Google. Studies conducted until May 9, 2020, that reports the prevalence of dyslipidemia among people living with DM were included. The DerSimonian and Laird random-effects model was used to determine the pooled prevalence of lipid profile abnormalities. Heterogeneity was checked using the I 2 statistic, whereas publication bias was tested by funnel plot and Egger's test. Besides, subgroup and sensitivity analyses were performed. Results We used 18 primary studies, including 4961 participants living with DM, which met the eligibility criteria for the meta-analysis of hypertriglyceridemia. The estimate of hypertriglyceridemia (≥150 mg/dl) was 48.15% (95% CI: 38.15-58.15, I 2 = 98.4%) after performing the main meta-analysis using the random-effects model. The subgroup analysis showed a higher pooled estimate of hypertriglyceridemia among T2DM (57.80% (95% CI: 50.50-65.10), I 2 = 92.5%), studies that used probability sampling technique (59.09% (95% CI: 43.58-74.59), I 2 = 98.6%, p < 0.001), and studies from primary data sources (51.43% (95% CI: 40.72-62.13), I 2 = 98.0%, p < 0.001). Moreover, the estimated pooled prevalence of the total plasma cholesterol (TC ≥ 200 mg/dl) was 34.08% (95% CI: 28.41-39.75, I 2 = 92.4%), LDL - C ≥ 100 mg/dl was 41.13% (95% CI: 27.15-55.11, I2 = 98.8%), and HDL ≤ 40 mg/dl for men and ≤ 50 mg/dl for women was 44.36% (95% CI: 31.82-56.90, I 2 = 98.8%). Conclusions The pooled prevalence of hypertriglyceridemia and other lipid abnormalities among DM patients was relatively high in Ethiopia. It strongly suggests the need to give maximal attention to the adherence of DM management to reduce the circulatory lipid profile abnormalities and subsequent complications. Prospero Registration. CRD42020182291.
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Walle B, Reba K, Debela Y, Tadele K, Biadglegne F, Gutema H. Prevalence of Metabolic Syndrome and Factors Associated With It Among Adults of West Gojjam: A Community-Based Cross-Sectional Study. Diabetes Metab Syndr Obes 2021; 14:875-883. [PMID: 33664582 PMCID: PMC7924118 DOI: 10.2147/dmso.s295451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/10/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Metabolic syndrome is a cluster of risk factors for cardiovascular diseases, indicating great clinical attention. However, much less attention has been given to metabolic syndrome in the study area. OBJECTIVE The objective of this study is to determine the prevalence of metabolic syndrome and its associated factors in the adult population of West Gojjam zone, Ethiopia. METHODS A community-based cross-sectional study was conducted in West Gojjam from September 15 to October 20, 2018. A total of 627 participants were randomly selected. The data were collected using the WHO STEP-wise approach for non-communicable diseases by contextualizing the instrument based on the study questions. The collected data were entered into and analyzed in SPSS version 20. Binary logistic regression was used to identify predictors of the dependent variable. The odds ratio was used to measure the strength of association between variables. For all statistical significance tests, the cut-off value set was p < 0.05 with CI of 95%. RESULTS In the studied region, high prevalence of metabolic syndrome at 17.3% is documented. In the final model, age (adjusted odds ratio [AOR] = 1.02, CI: 1.01-1. 05), occupation (AOR = 2.97, CI: 1.25-7.04), a moderate or high level of physical activity (AOR = 0.28, CI: 0.14-0.56 and AOR = 0.42, CI: 0.18-0.97) and type of oil used for cooking (AOR = 2.62, CI: 1.87-7.86) are significantly associated with metabolic syndrome. CONCLUSION The prevalence of metabolic syndrome in this study is high, and it is determined by age, occupation, physical activity and type of oil used for cooking. Designing an intervention which focuses on promoting a healthy lifestyle like physical activity and using oils which are liquid at room temperature to prevent the risk of major non-communicable diseases is needed.
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Affiliation(s)
- Bizuayehu Walle
- Department of Physiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir-Dar, Ethiopia
| | - Kidist Reba
- Department of Adult Health Nursing, School of Health Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir-Dar, Ethiopia
| | - Yamrot Debela
- Department of Health Education and Behavioural Sciences, School of Public Health, College of Medicine and Health Sciences, Bahir-Dar University, Bahir-Dar, Ethiopia
| | - Kassahun Tadele
- Department of Pathology, School of Medicine, College of Medicine and Health Sciences, Bahir-Dar University, Bahir-Dar, Ethiopia
| | - Fantahun Biadglegne
- Department of Medical Laboratory Sciences, School of Medicine, College of Medicine and Health Sciences, Bahir-Dar University, Bahir-Dar, Ethiopia
| | - Hordofa Gutema
- Department of Health Education and Behavioural Sciences, School of Public Health, College of Medicine and Health Sciences, Bahir-Dar University, Bahir-Dar, Ethiopia
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Gebreegziabiher G, Belachew T, Mehari K, Tamiru D. Magnitude and Associated Factors of Metabolic Syndrome Among Adult Urban Dwellers of Northern Ethiopia. Diabetes Metab Syndr Obes 2021; 14:589-600. [PMID: 33603424 PMCID: PMC7882458 DOI: 10.2147/dmso.s287281] [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: 10/22/2020] [Accepted: 01/27/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Metabolic Syndrome (MetS) is becoming a big public health problem in developing countries like Ethiopia. Developing countries have an almost two-fold higher risk of death due to non-communicable diseases (NCDs) compared to high-income countries. This study aimed to assess the magnitude and factors associated with MetS among adult residents of Mekelle city. METHODS A population-based cross-sectional study was carried out among 266 randomly selected adults from July to September 2019. Data were collected on socio-demographic, clinical, anthropometric, and lifestyle characteristics using a structured questionnaire adapted from the WHO STEPs survey tool. Fasting Blood Glucose (FBG) and lipid profiles were tested using a blood sample. Bivariate and multivariable logistic regression analyses were used to identify factors associated with MetS and variables were considered statistically significant at p ≤0.05. RESULTS The findings of this study showed the magnitude of MetS was 21.8%. The proportion of MetS was relatively higher among women (24.6%) than men (18.5%). Raised blood pressure was the most prominent (42.5%) component of MetS followed by central obesity (41.7%). The magnitude of the other components of MetS was 38.0%, 21.4%, and 14.3% for elevated triglyceride, raised FBG, and low HDL-C, respectively. Advanced age, medium and high monthly income, walking less than 10 minutes per day, raised Body Mass Index (BMI), higher waist to hip ratio, and elevated total cholesterol were significantly associated with a higher risk of metabolic syndrome. CONCLUSION In this study, we found a high prevalence of metabolic syndrome and its components, which highlights an urgent need for a public health strategy for its prevention, early diagnosis, and management.
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Affiliation(s)
- Gebremedhin Gebreegziabiher
- Department of Human Nutrition, Adigrat University, Adigrat, Ethiopia
- Correspondence: Gebremedhin Gebreegziabiher Jimma University, P.O. Box: +251378, Addis Ababa, Ethiopia Email
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | | | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Bekele BB, Manzar MD, Alqahtani M, Pandi-Perumal SR. Diabetes mellitus, metabolic syndrome, and physical activity among Ethiopians: A systematic review. Diabetes Metab Syndr 2021; 15:257-265. [PMID: 33484984 DOI: 10.1016/j.dsx.2020.12.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS The incidence of diabetes mellitus (DM) is increasing worldwide, and there is growing appreciation for the impact of limited physical activity on the disease. This study aimed to determine whether the current research on DM in Ethiopia has sufficiently identified and focused on the importance of limited physical activity according to the Global Physical Activity Questionnaire (GPAQ) in the disease etiology. METHODS This was a systematic review, performed according to the PRISMA checklist. We searched primary studies of diabetes, diabetes-related complications, determinants, and magnitude of related morbidities in Ethiopia in PubMed, Medline, and ISI Web of Science databases. Reviews, editorial communications, reports, and letters were excluded. RESULTS Among 363 articles that were identified from all databases, 28 were included. It was found that 39% of the studies measured and included limited physical activity as a predisposing lifestyle factor in diabetes, while 17.86% either did not report or did not include this variable at all. Although 42.86% of the studies identified limited physical activity as an etiological factor in diabetes, it was not measured according to the GPAQ guidelines. CONCLUSIONS These data suggest that Ethiopian researchers do not give sufficient attention to the role of physical activity and its definition per GPAQ as a preventative factor for reducing the severity of diabetes symptoms. We suggest that physical activity research and promotion should be advocated in Ethiopia, and that researchers should seek advice on how to re-frame their work in the future.
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Affiliation(s)
- Bayu Begashaw Bekele
- Public Health Department, College of Health Sciences, Mizan-Tepi University, 260, Mizan-Aman, Ethiopia; Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, 4028, Hungary.
| | - Md Dilshad Manzar
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia
| | - Mazen Alqahtani
- Department of Physiotherapy, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia
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Yang X, Lin Y, Xu GD, Chen YS, Zhou Y, Sun J, Li L. Optimal Cut-Off Values of Visceral Fat Area for Predicting Metabolic Syndrome Among Type 2 Diabetes Patients in Ningbo, China. Diabetes Metab Syndr Obes 2021; 14:1375-1383. [PMID: 33790605 PMCID: PMC8006810 DOI: 10.2147/dmso.s304164] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/02/2021] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To examine the optimal cut-off values of visceral fat area (VFA) for predicting metabolic syndrome (MetS) among type 2 diabetes (T2D) patients in Ningbo China. METHODS A total of 1017 subjects were selected from T2D patients who accepted standardized management by the National Standardized Metabolic Disease Management Center at Ningbo First Hospital from March 2018 to January 2020. Demography and medical information were collected through questionnaires. Regional adiposity was examined by a visceral fat analyzer using the dual bioelectrical impedance method. RESULTS Overall, 769 (75.6%) T2D patients were defined to have MetS. Patients with MetS had higher anthropometric values and biomarkers, compared to those without MetS. VFA was significantly correlated with risk factors of MetS. Further logistic regression models showed that VFA was significantly associated with MetS in men (OR=1.02) and in women (OR=1.03) (P<0.001 for both genders) after controlling for related factors. Receiver-operating characteristic curve analysis demonstrated that the optimal cut-off values of VFA were 84.7 cm2 for men and 81.1 cm2 for women to predict MetS in T2D patients. CONCLUSION VFA was associated with MetS and could be an independent predictor of MetS in T2D patients. CLINICAL TRIAL REGISTRATION www.ClinicalTrials.gov, number: NCT03811470.
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Affiliation(s)
- Xi Yang
- Department of Nutrition, Ningbo First Hospital, Ningbo, Zhejiang Province, People’s Republic of China
| | - Yi Lin
- Center for Health Economics, School of Economics, Faculty of Humanities and Social Sciences, University of Nottingham, Ningbo, Zhejiang Province, People’s Republic of China
| | - Guo-dong Xu
- Department of Medical Records Statistics, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang Province, People’s Republic of China
| | - Yan-shu Chen
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, Zhejiang Province, People’s Republic of China
| | - Ye Zhou
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, Zhejiang Province, People’s Republic of China
| | - Jing Sun
- Menzies Health Institute Queensland and School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Li Li
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, Zhejiang Province, People’s Republic of China
- Correspondence: Li Li Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, Zhejiang Province, People’s Republic of China Tel +86 137 5742 6626 Email
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Jairoun AA, Shahwan MJ, Khattab MH. A Comparative Assessment of Metabolic Syndrome and its Association with Vitamin D and Other Risk Factors in Type 2 Diabetes Mellitus Patients. Curr Diabetes Rev 2021; 17:233-242. [PMID: 32674733 DOI: 10.2174/1573399816666200716193115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 06/26/2020] [Accepted: 06/28/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To determine the overall prevalence of metabolic syndrome using the World Health Organization (WHO); National Cholesterol Education Program (NCEP), and the International Diabetes Federation (IDF) guidelines and to study its association with vitamin D and other biochemical parameters in patients with type 2 Diabetes mellitus, as well as to identify the set of biochemical parameters that jointly influence the metabolic syndrome using different diagnostic criteria. METHODS A cross-sectional study was carried out at a private health care center in -a total of 291 diabetic patients. Socio-demographic, clinical, and laboratory data were obtained from the medical records of patients. Statistical analysis was carried out using the Statistical Package for the Social Sciences (SPSS, version 23). RESULTS A total number of 291 patients with T2DM were included in this study. The overall prevalence of metabolic syndrome among the study subjects was 48.1%, 87.3%, 64.9% using the WHO, IDF, and NCEP-ATPIII criteria, respectively. The highest prevalence was reported following IDF diagnostic criteria. Sex, triglyceride, and fasting blood sugar were associated factors of metabolic syndrome by all the three diagnostic criteria of metabolic syndrome. CONCLUSION The study revealed a high prevalence rate of metabolic syndrome among type 2 diabetic patients, which was highest at 87.3% according to IDF and lowest was observed according to the WHO criteria i.e, 48.1%. A significant variance in the prevalence of metabolic syndrome was reported between WHO, IDF, and NCEP criteria.
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Affiliation(s)
- Ammar A Jairoun
- Health and Safety Department, Dubai Municipality, Dubai, United Arab Emirates
| | - Moyad J Shahwan
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Mohammed H Khattab
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
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Ambachew S, Endalamaw A, Worede A, Tegegne Y, Melku M, Biadgo B. The Prevalence of Metabolic Syndrome in Ethiopian Population: A Systematic Review and Meta-analysis. J Obes 2020; 2020:2701309. [PMID: 33489358 PMCID: PMC7803160 DOI: 10.1155/2020/2701309] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/05/2020] [Accepted: 11/30/2020] [Indexed: 01/02/2023] Open
Abstract
Background The metabolic syndrome is a clustering of hyperglycemia/insulin resistance, hypertension, dyslipidemia, and obesity which are risk factors for cardiovascular disease, type 2 diabetes and stroke, and all-cause mortality. The burden of metabolic syndrome is emerging alarmingly in low- and middle-income countries such as Ethiopia; however, there is lack of comprehensive estimation. This study aimed to determine the pooled prevalence of metabolic syndrome in Ethiopia. Methods This systematic review and meta-analysis included original articles of observational studies published in the English language. Searches were carried out in PubMed, Google Scholar, and Africa Journals from conception to August 2020. A random-effects model was used to estimate the pooled prevalence of metabolic syndrome in Ethiopia. Heterogeneity was assessed using the I 2 statistic. Subgroup analysis was also conducted based on sex/gender and study subjects. Egger's test was used to assess publication bias. Results Electronic and gray literature search retrieved 942 potentially relevant papers. After removing duplicates and screening with eligibility criteria, twenty-eight cross-sectional studies were included in this meta-analysis. The pooled prevalence of metabolic syndrome in Ethiopia was found to be 34.89% (95% CI: 26.77, 43.01) and 27.92% (95% CI: 21.32, 34.51) by using NCEP/ATP III and IDF criteria, respectively. The weighted pooled prevalence of metabolic syndrome was higher in females 36.74% (95% CI: 20.72, 52.75) and 34.09% (95% CI: 26.68, 41.50) compared to males 22.22% (95% CI: 14.89, 29.56) and 24.82% (95% CI: 18.34, 31.31) by using IDF and NCEP/ATP III criteria, respectively. Subgroup analysis based on the study subjects using NCEP/ATP III showed that the weighted pooled prevalence was 63.78%(95% CI: 56.17, 71.40), 44.55% (95% CI: 30.71, 52.38), 23.09% (95% CI: 19.74, 26.45), 20.83% (95% CI: 18.64, 23.01), and 18.45% (95% CI: 13.89, 23.01) among type 2 diabetes patients, hypertensive patients, psychiatric patients, HIV patients on HAART, and working adults, respectively. The most frequent metabolic syndrome components were low HDL-C 51.0% (95% CI: 42.4, 59.7) and hypertriglyceridemia 39.7% (95% CI: 32.8, 46.6). Conclusions The findings revealed an emerging high prevalence of metabolic syndrome in Ethiopia. Therefore, early intervention is required for the primary prevention of the occurrence of metabolic syndrome and the further reduction of the morbidity and mortality related to it.
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Affiliation(s)
- Sintayehu Ambachew
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Aklilu Endalamaw
- Departement of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abebaw Worede
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yalewayker Tegegne
- Department of Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Melku
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belete Biadgo
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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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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Saif-Ali R, Kamaruddin NA, AL-Habori M, Al-Dubai SA, Ngah WZW. Relationship of metabolic syndrome defined by IDF or revised NCEP ATP III with glycemic control among Malaysians with Type 2 Diabetes. Diabetol Metab Syndr 2020; 12:67. [PMID: 32774471 PMCID: PMC7405365 DOI: 10.1186/s13098-020-00575-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/29/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The chronic complications of Type 2 Diabetes (T2D) such as macrovascular disease is amplified with the increase in the number of metabolic syndrome (MetS) risk factors. This research aims to study the relationship of MetS, diagnosed by the International Diabetes Federation (IDF) or revised National Cholesterol Education Programs Adult Treatment Panel III (NCEP ATP III) criteria, with glycemic control, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), C-peptide, and insulin resistance in T2D patients. METHODS The study is a cross-sectional observational study which, involved 485 T2D patients who are receiving treatment at the University Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur, Malaysia. The MetS among the T2D patients was diagnosed based on IDF and revised NCEP ATP III criteria. C-peptide and HbA1c levels were determined by an automated quantitative immunoassay analyzer and high-performance liquid chromatography, respectively. The MetS factors; FBG, triglyceride, and high-density lipoprotein cholesterol were measured by spectrophotometer. RESULTS Application of the IDF and revised NCEP ATP III criteria respectively resulted in 73% and 85% of the T2D subjects being diagnosed with MetS. The concordance of these criteria in diagnosing MetS among T2D patients was low (κ = 0.33, P < 0.001). Both IDF and revised NCEP ATP III criteria indicated that T2D patients with 5 MetS factors had higher insulin resistance (P = 2.1 × 10-13; 1.4 × 10-11), C-peptide (P = 1.21 × 10-13; 4.1 × 10-11), FBG (P = 0.01; 0.021), and HbA1c (P = 0.039; 0.018) than those T2D patients without MetS, respectively. CONCLUSION Although there is a low concordance between IDF and revised NCEP ATP III criteria in the diagnosis of MetS among T2D patients, both criteria showed that T2D patients with 5 MetS factors had higher insulin resistance, C-peptide, FBG, and HbA1c.
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Affiliation(s)
- Riyadh Saif-Ali
- Biochemistry Department, Faculty of Medicine, Sana’a University, Sana’a, Yemen
| | - Nor Azmi Kamaruddin
- Internal Medicine, UKM Medical Centre, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Molham AL-Habori
- Biochemistry Department, Faculty of Medicine, Sana’a University, Sana’a, Yemen
| | - Sami A. Al-Dubai
- Joint Program of Family Medicine, Post Graduate Studies, Al-Madinah, Saudi Arabia
| | - Wan Zurinah Wan Ngah
- Genetic Unit, UKM Medical Molecular Biology Institute (UMBI), Kuala Lumpur, Malaysia
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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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Sinaga M, Yemane T, Tegene E, Lidstrom D, Belachew T. Performance of newly developed body mass index cut-off for diagnosing obesity among Ethiopian adults. J Physiol Anthropol 2019; 38:14. [PMID: 31655610 PMCID: PMC6815360 DOI: 10.1186/s40101-019-0205-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 09/04/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obesity is defined as unhealthy excess body fat, which increases the risk of premature mortality from noncommunicable diseases. Early screening and prevention of obesity is critical for averting associated morbidity, disability, and mortality. Ethiopia has been using the international (WHO's) BMI cut-off for diagnosing obesity even though its validity among Ethiopian population was questioned. To address this problem, a new body mass index cut-off was developed for Ethiopian adults using population-specific data. However, its performance in diagnosing obesity has not been validated. Therefore, this study determined the performance of the newly developed Ethiopian and World Health Organization (WHO) BMI cut-offs in detecting obesity among Ethiopian adults. METHODS A cross-sectional study was carried out among 704 employees of Jimma University from February to April 2015. The study participants were selected using simple random sampling technique based on their payroll. Data on sociodemographic variables were collected using an interviewer-administered structured questionnaire. Anthropometric parameters including body weight and height were measured according to WHO recommendation. Body fat percentage (BF%) was measured using the air displacement plethysmography (ADP) after calibration of the machine. The diagnostic accuracy of the WHO BMI cut-off (≥ 30 kg/m2) for obesity in both sexes and Ethiopian BMI cut-off (> 22.2 kg/m2 for males and > 24.5 kg/m2 for females) were compared to obesity diagnosed using ADP measured body fat percentage (> 35% for females and > 25% for males). Sensitivity, specificity, predictive values, and kappa agreements were determined to validate the performance of the BMI cut-offs. RESULTS In males, WHO BMI cut-off has a sensitivity of 5.3% and specificity of 99.4% (Kappa = 0.047) indicating a slight agreement. However, the Ethiopian cut-off showed a sensitivity of 87.5% and specificity of 87.7% (Kappa = 0.752) indicating a substantial agreement. Similarly, in females, the WHO BMI cut-off showed a sensitivity of 46.9%, while its specificity was 100% (Kappa = 0.219) showing a fair agreement. The Ethiopian BMI cut-off demonstrated a sensitivity 80.0% and a specificity 95.6% (Kappa = 0.701) showing a substantial agreement. The WHO BMI cut-off underestimated the prevalence of obesity by a maximum of 73.7% and by a minimum of 28.3% among males, while the values for underestimation ranged from 31.4-54.1% in females. The misclassification was minimal using the newly developed Ethiopian BMI cut-off. The prevalence of obesity was underestimated by a maximum of 9.2% and overestimated by a maximum of 6.2%. The WHO BMI cut-off failed to identify nearly half (46.6%) of Ethiopian adults who met the criteria for obesity using BF% in the overall sample. CONCLUSIONS The findings suggest that WHO BMI cut-off (≥ 30 kg/m2) is not appropriate for screening obesity among Ethiopian adults. The newly developed Ethiopian BMI cut-off showed a better performance with excellent sensitivity, specificity, predictive values, and agreement indicating the diagnostic significance of it use as a simple, cost-effective, and valid indicator in clinical and community setups.
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Affiliation(s)
- Makeda Sinaga
- Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, Po. Box 378, Jimma, Ethiopia
| | - Tilahun Yemane
- Faculty of Health Sciences, Department of Laboratory Sciences, Jimma University, Jimma, Ethiopia
| | - Elsah Tegene
- Department of Internal Medicine, Faculty of Medicine, Jimma University, Jimma, Ethiopia
| | - David Lidstrom
- Population Studies Centre, Brown University, Providence, USA
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, Po. Box 378, Jimma, Ethiopia
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Bishu KG, Jenkins C, Yebyo HG, Atsbha M, Wubayehu T, Gebregziabher M. Diabetes in Ethiopia: A systematic review of prevalence, risk factors, complications, and cost. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.obmed.2019.100132] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Bizuayehu Wube T, Mohammed Nuru M, Tesfaye Anbese A. A Comparative Prevalence Of Metabolic Syndrome Among Type 2 Diabetes Mellitus Patients In Hawassa University Comprehensive Specialized Hospital Using Four Different Diagnostic Criteria. Diabetes Metab Syndr Obes 2019; 12:1877-1887. [PMID: 31571962 PMCID: PMC6756827 DOI: 10.2147/dmso.s221429] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 09/06/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Recognition of MetS in type two diabetic patients is important in starting the appropriate preventive and therapeutic measures. The commonly used definitions of MetS have similarities and discrepancies. Different definitions defined metabolic syndrome differently. IDF, WHO, NCEP-ATP III, and the harmonized definitions were used frequently to determine the prevalence of metabolic syndrome. OBJECTIVES This study was aimed to investigate the prevalence of MetS and its associated factors among patients with type 2 Diabetes Mellitus using four definitions and to identify the concordance and the difference of these four definitions. METHODS A cross-sectional study was conducted from February 28 to May 30/2017 at Hawassa university comprehensive specialized hospital. The study involved 314 study participants selected by simple random sampling technique. Logistic regression was used to determine associated factors of metabolic syndrome, and kappa statistics was used to determine the concordance between different definitions of metabolic syndrome. In any cases, a p-value of <0.05 was considered to be statistically significant. RESULT The prevalence of metabolic syndrome according to IDF, WHO, harmonized, and NCEP-ATP III diagnostic criteria was 59.9%, 31.2%, 65.6%, and 70.1%, respectively. Our study found the maximum agreement between IDF and NCEP criteria (K=0.54, P<0.001) and IDF and Harmonized(K=0.65, P<0.001). Uric acid level was associated factor of metabolic syndrome by all the four definitions, and total cholesterol was associated factors by the three definitions. CONCLUSION The prevalence of metabolic syndrome varies based on the definition used and the highest prevalence of MetS was observed with NCEP-ATP III and the different types of criteria do not always diagnose the same group of individuals.
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Affiliation(s)
- Temesgen Bizuayehu Wube
- School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- Correspondence: Temesgen Bizuayehu Wube School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, P.O. Box:1560, Hawassa, EthiopiaTel +251 916604551 Email
| | | | - Adane Tesfaye Anbese
- Department of Public Health, School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
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