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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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Determinants of metabolic syndrome and its prognostic implications among stroke patients in Africa: Findings from the Stroke Investigative Research and Educational Network (SIREN) study. J Neurol Sci 2022; 441:120360. [PMID: 35985161 DOI: 10.1016/j.jns.2022.120360] [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: 05/04/2022] [Revised: 07/20/2022] [Accepted: 07/25/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND The prognostic implications of metabolic syndrome (METS) among African stroke patients are poorly understood. This study aimed to investigate the determinants of METS and its prognostic implications among Africans with newly diagnosed stroke in the SIREN study. METHODS We included stroke cases (adults aged >18 years with CT/MRI confirmed stroke). The validated tools comprehensively evaluated vascular, lifestyle, and psychosocial factors. We used logistic regression to estimate adjusted odds ratios (OR) with 95% CIs for the association between METS and risk factors. We also computed the prediction power of the domain of covariates in a sequential manner using the area under the receiver operating curve (ROC) curve. RESULTS Among 3998 stroke subjects enrolled in the study, 76.8% had METS by at least one of the clinical definitions. Factors associated with METS were age > 50 years (OR- 1.46, CI-1.19-1.80), male gender (OR 4.06, CI- 3.28-5.03), income >100USD (OR1.42, CI-1.17-1.71), stress (OR1.46, CI-1.14-1.87), family history of diabetes mellitus (OR1.38, CI-1.06-1.78), and cardiac disease (OR1.42, CI-1.18-1.65). Stroke severity was higher among those with METS (SLS = 5.8 ± 4.3) compared with those without METS (6.2 ± 4.5) at p = 0.037. METS was associated with higher odds (aOR 1.31, CI-1.08-1.58) of one-month fatality after adjusting for stroke severity, age > 50 years, and average monthly income >100USD. CONCLUSION METS is very common among African stroke patients and is associated with stroke severity and worse one-month fatality. Lifestyle interventions may prevent METS and attenuate its impact on stroke occurrence and outcomes.
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Zhang F, Liu L, Zhang C, Ji S, Mei Z, Li T. Association of Metabolic Syndrome and Its Components With Risk of Stroke Recurrence and Mortality: A Meta-analysis. Neurology 2021; 97:e695-e705. [PMID: 34321360 DOI: 10.1212/wnl.0000000000012415] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/19/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Because metabolic syndrome is a significant risk factor for cardio-cerebrovascular diseases and the relationship between metabolic syndrome (including its components) and the prognosis of stroke is controversial, this study was conducted to evaluate whether metabolic syndrome is associated with a high recurrence and mortality of stroke. METHODS This study was registered in the PROSPERO database (CRD42020177118). We searched for relevant observational cohort studies published from inception to April 23, 2020, using PubMed, Embase, and the Cochrane Library. Effect estimates with 95% confidence intervals (CIs) were pooled using the random-effects model. The primary and secondary outcomes were stroke recurrence and all-cause mortality, respectively. Leave-one-out sensitivity analyses and nonparametric trim-and-fill method were used to identify the stability of the results. RESULTS Thirteen cohort studies comprising 59,919 participants >60 years of age were included for analysis. Overall, metabolic syndrome was significantly associated with stroke recurrence (relative risk [RR] 1.46, 95% CI 1.07-1.97, p = 0.02). Among the metabolic syndrome components, low levels of high-density lipoprotein cholesterol (HDL-C) (RR 1.32, 95% CI 1.11-1.57, p = 0.002) and ≥2 metabolic syndrome components (RR 1.68, 95% CI 1.44-1.94, p < 0.001) significantly predicted stroke recurrence, whereas elevated triglycerides, elevated waist circumference, hyperglycemia, and hypertension failed to account for risk factors for stroke recurrence. Moreover, metabolic syndrome, not its components, was significantly associated with all-cause mortality (RR 1.27, 95% CI 1.18-1.36, p < 0.001). The stability of these results was further confirmed by the leave-one-out sensitivity analyses and nonparametric trim-and-fill method. CONCLUSIONS The present study indicates that metabolic syndrome and some of its components (low HDL-C and number of metabolic syndrome components) seem to be risk factors for stroke recurrence. Although metabolic syndrome is also associated with all-cause mortality, the role of its components in predicting all-cause mortality deserves further study.
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Affiliation(s)
- Fangfang Zhang
- From the Second Department of Neurology (F.F.), Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University; National Clinical Research Center for Metabolic Diseases (L.L.), Metabolic Syndrome Research Center, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha; Department of Gastrointestinal Surgery (C.Z.), The Fourth Affiliated Hospital of China Medical University, Shenyang; Department of Pharmacy (S.J.), The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou; Department of Anorectal Surgery (Z.M.), Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Anorectal Disease Institute of Shuguang Hospital (Z.M.), Shanghai, China, and School of Basic Medicine (T.L.), Fourth Military Medical University, Xi'an, China
| | - Lili Liu
- From the Second Department of Neurology (F.F.), Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University; National Clinical Research Center for Metabolic Diseases (L.L.), Metabolic Syndrome Research Center, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha; Department of Gastrointestinal Surgery (C.Z.), The Fourth Affiliated Hospital of China Medical University, Shenyang; Department of Pharmacy (S.J.), The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou; Department of Anorectal Surgery (Z.M.), Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Anorectal Disease Institute of Shuguang Hospital (Z.M.), Shanghai, China, and School of Basic Medicine (T.L.), Fourth Military Medical University, Xi'an, China
| | - Chundong Zhang
- From the Second Department of Neurology (F.F.), Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University; National Clinical Research Center for Metabolic Diseases (L.L.), Metabolic Syndrome Research Center, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha; Department of Gastrointestinal Surgery (C.Z.), The Fourth Affiliated Hospital of China Medical University, Shenyang; Department of Pharmacy (S.J.), The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou; Department of Anorectal Surgery (Z.M.), Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Anorectal Disease Institute of Shuguang Hospital (Z.M.), Shanghai, China, and School of Basic Medicine (T.L.), Fourth Military Medical University, Xi'an, China
| | - Shiliang Ji
- From the Second Department of Neurology (F.F.), Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University; National Clinical Research Center for Metabolic Diseases (L.L.), Metabolic Syndrome Research Center, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha; Department of Gastrointestinal Surgery (C.Z.), The Fourth Affiliated Hospital of China Medical University, Shenyang; Department of Pharmacy (S.J.), The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou; Department of Anorectal Surgery (Z.M.), Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Anorectal Disease Institute of Shuguang Hospital (Z.M.), Shanghai, China, and School of Basic Medicine (T.L.), Fourth Military Medical University, Xi'an, China
| | - Zubing Mei
- From the Second Department of Neurology (F.F.), Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University; National Clinical Research Center for Metabolic Diseases (L.L.), Metabolic Syndrome Research Center, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha; Department of Gastrointestinal Surgery (C.Z.), The Fourth Affiliated Hospital of China Medical University, Shenyang; Department of Pharmacy (S.J.), The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou; Department of Anorectal Surgery (Z.M.), Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Anorectal Disease Institute of Shuguang Hospital (Z.M.), Shanghai, China, and School of Basic Medicine (T.L.), Fourth Military Medical University, Xi'an, China.
| | - Tian Li
- From the Second Department of Neurology (F.F.), Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University; National Clinical Research Center for Metabolic Diseases (L.L.), Metabolic Syndrome Research Center, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha; Department of Gastrointestinal Surgery (C.Z.), The Fourth Affiliated Hospital of China Medical University, Shenyang; Department of Pharmacy (S.J.), The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou; Department of Anorectal Surgery (Z.M.), Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Anorectal Disease Institute of Shuguang Hospital (Z.M.), Shanghai, China, and School of Basic Medicine (T.L.), Fourth Military Medical University, Xi'an, China
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Li X, Zhai Y, Zhao J, He H, Li Y, Liu Y, Feng A, Li L, Huang T, Xu A, Lyu J. Impact of Metabolic Syndrome and It's Components on Prognosis in Patients With Cardiovascular Diseases: A Meta-Analysis. Front Cardiovasc Med 2021; 8:704145. [PMID: 34336959 PMCID: PMC8319572 DOI: 10.3389/fcvm.2021.704145] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/21/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Patients with metabolic syndrome (MetS) have a higher risk of developing cardiovascular diseases (CVD). However, controversy exists about the impact of MetS on the prognosis of patients with CVD. Methods: Pubmed, Cochrane library, and EMBASE databases were searched. Cohort Studies and randomized controlled trials post hoc analyses that evaluated the impact of MetS on prognosis in patients (≥18 years) with CVD were included. Relative risk (RR), hazard rate (HR) and 95% confidence intervals (CIs) were calculated for each individual study by random-effect model. Subgroup analysis and meta-regression analysis was performed to explore the heterogeneity. Results: 55 studies with 16,2450 patients were included. Compared to patients without MetS, the MetS was associated with higher all-cause death [RR, 1.220, 95% CI (1.103 to 1.349), P, 0.000], CV death [RR, 1.360, 95% CI (1.152 to 1.606), P, 0.000], Myocardial Infarction [RR, 1.460, 95% CI (1.242 to 1.716), P, 0.000], stroke [RR, 1.435, 95% CI (1.131 to 1.820), P, 0.000]. Lower high-density lipoproteins (40/50) significantly increased the risk of all-cause death and CV death. Elevated fasting plasma glucose (FPG) (>100 mg/dl) was associated with an increased risk of all-cause death, while a higher body mass index (BMI>25 kg/m2) was related to a reduced risk of all-cause death. Conclusions: MetS increased the risk of cardiovascular-related adverse events among patients with CVD. For MetS components, there was an increased risk in people with low HDL-C and FPG>100 mg/dl. Positive measures should be implemented timely for patients with CVD after the diagnosis of MetS, strengthen the prevention and treatment of hyperglycemia and hyperlipidemia.
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Affiliation(s)
- Xiao Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Department of Clinical Medicine, Qinghai Institute of Health Sciences, Xining, China
| | - Yajing Zhai
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Medical University, Xi'an, China
| | - Jiaguo Zhao
- Department of Orthopaedic Surgery, Tianjin Hospital, Tianjin, China
| | - Hairong He
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yuanjie Li
- Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Yue Liu
- Xiyuan Hospital of China Academy of Chinese Medicinal Sciences, Beijing, China
| | - Aozi Feng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Tao Huang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Anding Xu
- Department of Neurology, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
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Noorani KPM, Nazeer RA. Enzymatic Production of Two Tri-peptides on ACE-I Inhibition and Antioxidant Activities. Int J Pept Res Ther 2020. [DOI: 10.1007/s10989-020-10037-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Haley MJ, Krishnan S, Burrows D, de Hoog L, Thakrar J, Schiessl I, Allan SM, Lawrence CB. Acute high-fat feeding leads to disruptions in glucose homeostasis and worsens stroke outcome. J Cereb Blood Flow Metab 2019; 39:1026-1037. [PMID: 29171775 PMCID: PMC6545621 DOI: 10.1177/0271678x17744718] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Chronic consumption of diets high in fat leads to obesity and can negatively affect brain function. Rodents made obese by long-term maintenance on a high-fat diet have worse outcome after experimental stroke. High-fat consumption for only three days does not induce obesity but has rapid effects on the brain including memory impairment. However, the effect of brief periods of high-fat feeding or high-fat consumption in the absence of obesity on stroke is unknown. We therefore tested the effect of an acute period of high-fat feeding (three days) in C57B/6 mice on outcome after middle cerebral artery occlusion (MCAo). In contrast to a chronic high-fat diet (7.5 months), an acute high-fat diet had no effect on body weight, adipose tissue, lipid profile or inflammatory markers (in periphery and the brain). Three days of high-fat feeding impaired glucose tolerance, increased plasma glucose and insulin and brain expression of the glucose transporter GLUT-1. Ischaemic damage was increased (48%) in mice fed an acute high-fat diet, and was associated with a further reduction in GLUT-1 in the ischaemic hemisphere. These data demonstrate that only a brief period of high-fat consumption has a negative effect on glucose homeostasis and worsens outcome after ischaemic stroke.
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Affiliation(s)
- Michael J Haley
- Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, UK
| | - Siddharth Krishnan
- Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, UK
| | - David Burrows
- Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, UK
| | - Leon de Hoog
- Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, UK
| | - Jamie Thakrar
- Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, UK
| | - Ingo Schiessl
- Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, UK
| | - Stuart M Allan
- Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, UK
| | - Catherine B Lawrence
- Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, UK
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Balde N, Camara A, Sobngwi-Tambekou J, Balti EV, Tchatchoua A, Fezeu L, Limen S, Ngamani S, Ngapout S, Kengne AP, Sobngwi E. Improving access to HbA1c in sub-Saharan Africa (IA3) cohort: cohort profile. Pan Afr Med J 2017; 27:275. [PMID: 29187944 PMCID: PMC5660907 DOI: 10.11604/pamj.2017.27.275.10270] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 11/18/2016] [Indexed: 12/27/2022] Open
Abstract
Introduction Glycated haemoglobin (HbA1c) is the best surrogate of average blood glucose control in diabetic patients, and lowering HbA1c significantly reduces diabetes complications. Moreover, immediate feedback of HbA1c measurement to patients may improve control. However, HbA1c is unavailable in most parts of Africa, a continent with one of the highest burden of diabetes. To translate these evidences, we are conducting a multicentric project in 10 health care facilities in Guinea and Cameroon to evaluate the feasibility and one-year benefit of affordable HbA1c measurement with immediate feedback to patients on diabetes control and related outcomes. Participants We consecutively enrolled patients with diabetes mellitus independently of the type of disease. We hypothesised an average 1%-decrease in HbA1c in a 1000-patient study population, with a 20% increase in the number of patients reaching treatment goals within 12 months of intervention and follow-up. Findings to date A total of 1, 349 diabetic patients aged 56.2±12.6 years are enrolled (813 in Cameroon and 536 in Guinea) of whom 59.8% are women. The mean duration of diabetes is 7.4±6.3 years and baseline HbA1c is 9.7±2.6% in Guinea and 8.6±2.5% in Cameroon. Future plans To investigate whether the introduction of routine HbA1c measurement with immediate feedback to patients and provision of relevant education would improve diabetes control after one year. The impact of the intervention on diabetes associated-complications and mortality warrant further assessment in the long term.
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Affiliation(s)
- Naby Balde
- University Hospital Donka, Conakry, Guinea
| | | | - Joelle Sobngwi-Tambekou
- Catholic University of Central Africa, Yaoundé, Cameroon.,Recherche Santé Développement, Yaoundé, Cameroon
| | - Eric Vounsia Balti
- Recherche Santé Développement, Yaoundé, Cameroon.,Diabetes Research Center, Faculty of Medicine and Pharmacy, Free University of Brussels-VUB, Brussels, Belgium.,Universitair Ziekenhuis Brussel- UZ Brussel, Brussels, Belgium
| | | | | | - Serge Limen
- Recherche Santé Développement, Yaoundé, Cameroon
| | | | | | - Andre Pascal Kengne
- South African Medical Research Council and University of Cape Town, Cape Town, South Africa
| | - Eugene Sobngwi
- Recherche Santé Développement, Yaoundé, Cameroon.,Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
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Metabolic Syndrome and the Risk of Ischemic Stroke. J Stroke Cerebrovasc Dis 2017; 26:286-294. [DOI: 10.1016/j.jstrokecerebrovasdis.2016.09.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 08/20/2016] [Accepted: 09/13/2016] [Indexed: 01/24/2023] Open
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Metabolic Syndrome Augments the Risk of Early Neurological Deterioration in Acute Ischemic Stroke Patients Independent of Inflammatory Mediators: A Hospital-Based Prospective Study. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:8346301. [PMID: 27119010 PMCID: PMC4828543 DOI: 10.1155/2016/8346301] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 03/17/2016] [Indexed: 01/06/2023]
Abstract
Background and Aims. Metabolic syndrome (MetS) has been associated with occurrence and prognosis of ischemic stroke. This study aimed to evaluate whether an association exists between MetS and early neurological deterioration (END) following acute ischemic stroke and the possible role inflammatory biomarkers play. Methods and Results. We conducted a prospective cohort investigation that involved 208 stroke patients within 48 hours from symptom onset. MetS was determined by the modified National Cholesterol Education Program/Adult Treatment Panel III criteria. END was defined as an increase of ⩾1 point in motor power or ⩾2 points in the total National Institutes of Health Stroke Scale (NIHSS) score within 7 days. Univariate logistic regression analysis showed that patients with MetS had a 125% increased risk of END (OR 2.25; 95% CI 1.71–4.86, P = 0.005). After adjustment for fibrinogen and high-sensitivity C-reactive protein, MetS remained significantly correlated to END (OR 2.20; 95% CI 1.10–4.04, P = 0.026) with a 77% elevated risk per additional MetS trait (OR 1.77; 95% CI 1.23–2.58, P = 0.002). Conclusions. This study demonstrated that MetS may be a potential predictor for END after ischemic stroke, which was independent of raised inflammatory mediators.
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Song QB, Zhao Y, Liu YQ, Zhang J, Xin SJ, Dong GH. Sex difference in the prevalence of metabolic syndrome and cardiovascular-related risk factors in urban adults from 33 communities of China: The CHPSNE study. Diab Vasc Dis Res 2015; 12:189-98. [PMID: 25670848 DOI: 10.1177/1479164114562410] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Little is known about the epidemiology of metabolic syndrome in urban areas of China. To estimate the prevalence of MetS and identify its cardiovascular-related factors in men and women, a representative sample of 15,477 urban adults aged 18-74 years in Northeast China was selected from 2009 to 2010. The diagnosis of metabolic syndrome was based on criteria set by the National Cholesterol Education Program/Adult Treatment Panel. The overall prevalence of metabolic syndrome was 27.4% (men 27.9% and women 26.8%). Multivariable logistic regression analysis revealed that a higher education level and a higher family income were associated with a higher prevalence of metabolic syndrome in men, but associated with lower prevalence of metabolic syndrome among women. Higher physical activity was associated with a decreased prevalence of metabolic syndrome in men (adjusted odds ratios (aORs) = 0.88, 95% confidence interval (CI): 0.79-0.99), but associated with an increased prevalence of metabolic syndrome in women (aOR = 1.14, 95% CI: 1.00-1.29). Compared with rice as the major staple food, cooked wheaten foods were associated with lower adjusted odds for metabolic syndrome both in men (aOR = 0.72, 95% CI: 0.58-0.90) and in women (aOR = 0.72, 95% CI: 0.56-0.92). In conclusion, metabolic syndrome is highly prevalent in urban areas of China, and there is heterogeneity by sex in the relationships between risk factors and metabolic syndrome prevalence.
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Affiliation(s)
- Qing-Bin Song
- Department of General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China
| | - Yang Zhao
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, People's Republic of China
| | - Yu-Qin Liu
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, People's Republic of China
| | - Jian Zhang
- Department of General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China
| | - Shi-Jie Xin
- Department of General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China
| | - Guang-Hui Dong
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, People's Republic of China
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Cockburn L, Fanfon TN, Bramall A, Ngole EM, Kuwoh P, Anjonga E, Difang BME, Kiani S, Muso PS, Trivedi N, Sama J, Teboh S. Best practice guidelines for stroke in Cameroon: An innovative and participatory knowledge translation project. Afr J Disabil 2014; 3:92. [PMID: 28729996 PMCID: PMC5433442 DOI: 10.4102/ajod.v3i1.92] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 05/22/2014] [Indexed: 11/14/2022] Open
Abstract
Background Although the adherence to stroke guidelines in high-income countries has been shown to be associated with improved patient outcomes, the research, development and implementation of rehabilitation related guidelines in African countries is lacking. Objectives The purpose of this article is to describe how a group of front-line practitioners collaborated with academics and students to develop best practice guidelines (BPG) for the management and rehabilitation of stroke in adult patients in Cameroon. Method A working group was established and adapted internationally recognised processes for the development of best practice guidelines. The group determined the scope of the guidelines, documented current practices, and critically appraised evidence to develop guidelines relevant to the Cameroon context. Results The primary result of this project is best practice guidelines which provided an overview of the provision of stroke rehabilitation services in the region, and made 83 practice recommendations to improve these services. We also report on the successes and challenges encountered during the process, and the working group’s recommendations aimed at encouraging others to consider similar projects. Conclusion This project demonstrated that there is interest and capacity for improving stroke rehabilitation practices and for stroke guideline development in Africa.
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Affiliation(s)
- Lynn Cockburn
- Department of Occupational Science and Occupational Therapy, University of Toronto, Canada
| | | | - Alexa Bramall
- Undergraduate Medical Education MD Program, Faculty of Medicine, University of Toronto, Canada
| | - Eta M Ngole
- Buildings Bridges Cameroon (BBCAM), Yaoundé, Cameroon.,Ministry of Public Health, North West Region, Cameroon
| | - Pius Kuwoh
- Director, Regional Hospital, Limbe South West Region, Cameroon
| | | | | | | | - Petra S Muso
- St. Elizabeth's Catholic General Hospital, Shisong, Banso, Cameroon
| | | | - Julius Sama
- Ministry of Public Health, North West Region, Cameroon
| | - Sylvian Teboh
- St. Joseph's Children's and Adults Home (SAJOCAH), Bafut, Cameroon
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Ayina Ayina CN, Boudou P, Fidaa I, Balti EV, Sobngwi E, Etoundi Ngoa LS, Gautier JF. Osteoprotegerin is not a determinant of metabolic syndrome in sub-Saharan Africans after age adjustment. ANNALES D'ENDOCRINOLOGIE 2014; 75:165-70. [PMID: 25063075 DOI: 10.1016/j.ando.2014.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 04/05/2014] [Accepted: 05/14/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Osteoprotegerin (OPG), a soluble member of tumor necrosis factor receptor superfamily that inhibits bone resorption, has been suggested as a cardiovascular risk factor in humans. In this study, we aim to investigate the potential relationship between OPG and MetS (MetS) in a sub-Saharan African population. METHODS Four hundred and eleven volunteers (152 men, 259 women) aged ≥18 years recruited from the general population in Douala and Edea, Cameroon participated in this study. Anthropometric parameters measured and blood samples were collected for glucose, serum lipids and OPG concentrations measurements. Mean differences of the variables in different groups were compared using Students' t test. We performed logistic regressions to analyze the impact of independent factors on the relation between OPG and MetS outcome. MetS was defined using the Joint Interim Statement 2009. RESULTS OPG levels did not vary significantly between both men and women with and without MetS (both P>0.05). However, with high fasting blood glucose (≥5.6 mmol/L) had a significantly higher OPG level than those with lower glucose level (P=0.014). In multiple logistic regression analysis, MetS did not show any significant association with serum OPG levels in men and women after adjusting for age, physical activity, alcohol consumption and menopausal status in women (P=0.720 and P=0.930 respectively). CONCLUSION This study failed to demonstrate any relationship between OPG and MetS. Nevertheless, the positive association between blood glucose and OPG levels reveals that OPG might be involved in cardiovascular risk development in this sub-Saharan African population.
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Affiliation(s)
| | - Philippe Boudou
- Department of hormonal biology, Saint-Louis hospital, university Paris-Diderot Paris-7, PO Box 75010, Public assistance-Paris Hospitals, 75013 Paris, France; UMR-S Inserm 872, Cordeliers research center, Pierre et Marie-Curie university Paris-6, Paris, France
| | - Ibrahim Fidaa
- Department of hormonal biology, Saint-Louis hospital, university Paris-Diderot Paris-7, PO Box 75010, Public assistance-Paris Hospitals, 75013 Paris, France
| | - Eric Vounsia Balti
- Diabetes research center, Brussels Free university-VUB, Brussels, Belgium
| | - Eugene Sobngwi
- Institute of health and society, university of Newcastle upon Tyne, UK; Department of internal medicine, national obesity center, faculty of medicine and biomedical sciences, university of Yaounde I, P.O. Box 7535, Yaounde, Cameroon.
| | - Laurent Serge Etoundi Ngoa
- Department of animal science, higher teacher's training college, university of Yaounde I, Yaounde, Cameroon
| | - Jean François Gautier
- University center of diabetes and complications in Lariboisière hospital, university Paris-Diderot Paris-7, Public assistance-Paris Hospitals, Paris, France; UMR-S Inserm 872, Cordeliers research center, Pierre et Marie-Curie university Paris-6, Paris, France
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