Epidemiology of Metabolic Syndrome among Adult Nigerians in a Rural Hospital in Eastern Nigeria
Science Journal of Public Health
Volume 2, Issue 2, March 2014, Pages: 135-143
Received: Mar. 20, 2014;
Accepted: Apr. 8, 2014;
Published: Apr. 10, 2014
Views 2987 Downloads 133
Gabriel Uche Pascal Iloh, Department of Family Medicine, Federal Medical Centre, Umuahia, Abia state, Nigeria
Godwin Oguejiofor Chukwuebuka Okafor, Department of Community Medicine, Federal Medical Centre, Umuahia, Abia state, Nigeria
Agwu NkwaAmadi, Department of Public Health Technology, Federal University of Technology, Owerri, Imo state, Nigeria
Background: Biological and socio-behavioural variations exist in the epidemiology of metabolic syndrome (MetS). As the case detection of MetS increases in Nigeria describing its prevalence and risk factors remain relevant for proactive control interventions. Aim: This study was designed to describe the epidemiology of MetS among adult Nigerians in a rural hospital in Eastern Nigeria. Materials and Methods: A cross sectional study was carried out on 365 adult patients who were screened for MetS using International Diabetes Federation(IDF) criteria: An Individual was considered to have MetS in the presence of WC ≥94 cm for men and ≥80 cm for women plus any two or more of the following: systolic and/or diastolic blood pressure ≥130/85 mmHg and/or hypertension on treatment; fasting blood glucose ≥ 100mg/dL and/or diabetes mellitus on treatment; triglyceride level ≥150 mg/dL and/or hypertriglyceridaemia on treatment and high density lipoprotein(HDL-C) cholesterol <40mg/dL for men or <50 mg/dL for women and/or HDL-C dyslipidaemia on treatment. The data collected included basic demographic variables, metabolic and nutri-behavioural risk factors. Results: The prevalence of MetS was 34.0%. MetS was significantly associated with old age(p=0.029), female sex(p=0.016) and physical inactivity(p=0.002). The most significant predictor of MetS was physical inactivity.(p=0.014, OR=4.58(1.52-9.63). The patients with MetS were four and half times more likely to be physically inactive compared to their non-MetS counterparts. Conclusion: This study has shown that MetS exist among the study population. The risk factors significantly associated with MetS were old age, female sex and physical inactivity. The most significant predictor variable was physical inactivity. Early primary and secondary prevention interventions should be a compelling health priority in the study area.
Gabriel Uche Pascal Iloh,
Godwin Oguejiofor Chukwuebuka Okafor,
Epidemiology of Metabolic Syndrome among Adult Nigerians in a Rural Hospital in Eastern Nigeria, Science Journal of Public Health.
Vol. 2, No. 2,
2014, pp. 135-143.
Tokin A. The metabolic syndrome: A growing problem. European Heart Journal Supplement 2004; 6: A32-A42.
Alberti KG, Eckel RH, Grundy SM. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120: 1640-45.
Alberti KG, Zimmet P, Shaw J. Metabolic syndrome-a new world-wide definition. A consensus statement from the International Diabetes Federation. Diabet Med 2006; 23: 469-80.
Miranda PJ, Defronzo RA, Califf RM, Guyton JR. Metabolic syndrome: definition, pathophysiology and mechanisms. Am Heart J 2005; 149: 33-45.
Kelliny C, William J, Riesen W, Paccaud F, Bovet P. Metabolic syndrome according to different definitions in a rapidly developing country of the African region. Cardiovasc Diabetol 2008; 7: 27.
Grundy SM, Brewer FIB, Cleeman JI. Definition of metabolic syndrome: report of the National Heart, Lung and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 2004; 109: 433-8.
Balkau B, Charles MA. Comment on the provisional report from THE WHO CONSULTATION. European Group for the study of Insulin Resistance(EGIR) Diabet Med 1999; 16: 442-3
Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: An American Heart Association/ National Heart, Lung and Blood Institute scientific statement. Circulation 2005; 112: 2735-52.
Einhorn D, Reaven GM, Cobin RH, et al. American College of Endocrinology position statement on the insulin resistance syndrome. Endocr Pract 2003; 9: 237-52.
Fezeu L, Balkau B, Kengne AP, Sobngwi E, Mbanya JC. Metabolic syndrome in a sub-Saharan African setting: central obesity may be the key determinant. Atherosclerosis 2007; 193: 70-6.
Akintunde AA, Ayodele OE, Akinwusi PO, Opadijo GO. Metabolic syndrome: Comparison of occurrence using three definitions in hypertensive patients. Clin Med Res 2011; 9: 26-31.
Ismail MF. Metabolic syndrome among obese Qataris attending primary health care centers in Doha. 2010. J Fam Community Med 2012; 19: 7-11.
Pemminati S, Prabha Adhikari MR, Pathak R, Pai MR. Prevalence of metabolic syndrome(METS) using IDF 2005 guidelines in a semi urban south Indian(Boloor Diabetes Study) population of Mangalore. J Assoc Physicians India 2010; 58: 674-7.
Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: Findings from the Third National Health and Nutrition Examination Survey. JAMA 2002; 287: 356-9.
Al-Nozha M, Al-Khadra A, Arafah MR, Al-Maatouq MA, Khalil MZ, Khan NB, et al. Metabolic syndrome in Saudi Arabia. Saudi Med J 2005; 26: 1918-25.
Tran A, Gelaye B, Girma B, Lemma S, Berhane Y, Bekele T, et al. Prevalence of metabolic syndrome among working adults in Ethiopia. Int J Hypertens 2011.
Gyakobo M, Amoah AGB, Martey-Marbell D, Snow RC. Prevalence of the metabolic syndrome in a rural population in Ghana. BMC Endocr Disord 2012; 12: 25.
Ulasi II, Ijoma CK, Onodugo OD. A community-based study of hypertension and cardio-metabolic syndrome in semi-urban and rural communities in Nigeria. BMC Health Serv Res 2010; 10: 71
Adediran O, Akintunde AA, Edo AE, Opadijo OG, araoye AM. Impact of urbanization and gender on frequency of metabolic syndrome among native Abuja settlers in Nigeria. J Cardiovasc Dis Res 2012; 3: 191-6.
Surana SP, Shah DB, Gala K, Hoskote SS, Gill N, Joshi AR, et al. Prevalence of metabolic syndrome in an Indian population using the NCEP ATP III. J Assoc Physicians India 2008; 56: 865-8.
Osuji CU, Nzerem BA, Dioka CE, Onwubuya EI. Metabolic syndrome in newly diagnosed type 2 diabetes mellitus using NCEP-ATP III, the Nnewi experience. Niger J Clin Pract 2012; 15: 475-80.
Alebiosu Co, Odusan BO. Metabolic Syndrome in subjects with type 2 diabetes mellitus J Natl Med. Assoc. 2004, 96: 817 – 21.
Isezuo SA. Is high density lipoprotein cholesterol useful in diagnosis of metabolic syndrome in native Africans with type 2 diabetes? Ethn Dis 2005; 15: 6-10.
Termizy HM, Matauzy M. Metabolic syndrome and its characteristics among obese patients attending an obesity clinic. Singpore Med J 2009; 50: 390-4.
Marchesini G, Melchionda N, Apolone G, Cuzzolaro M, Mannucci E, Grossi E. The metabolic syndrome in treatment seeking obese persons. Metabolism 2004; 53: 435 -40.
Meigs JB, Larson MG, D’Agostino RB. Coronary artery calcification in type 2 diabetes and insulin resistance. The Famingham Offspring Study. Diabetes Care 2002; 25: 1313-19.
Isezuo SA, Ezunu E. Demographic and clinical correlates of metabolic syndrome in native African type 2 diabetic patients. J Natl Med Assoc 2005; 97: 557-63.
Liu S, Manson JE. Dietary carbohydrates, physical inactivity, obesity and the ‘metabolic syndrome’ as predictors of coronary heart disease. Curr Opin Lipidol 2001; 12: 395-404.
Park HS, Oh SW, Cho WH, Kim YS. The metabolic syndrome and associated lifestyle factor among South Korean adults. Int J Epidemiol 2004; 33: 328-36.
Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet 2005; 365: 1415-28.
Lemieux I, Pascot A, Couillard C, Lamarche B, Tchernof A, Almeras N, et al. Hypertriglyceridemic waist: a marker of the atherogenic metabolic triad(hyperinsulinemia, hyperapolipoprotein B, small dense LDL) in men. Circulation; 102: 179-84.
Alshehri AM. Metabolic syndrome and cardiovascular risk. J Fam Community Med 2010; 17: 73-8
Habib SS. Cardiovascular disease in diabetes: An enigma of dyslipidaemia, thrombosis and inflammation. Basic Res J Med Clin Sci 2012; 1: 33-42.
Nesto RW. Correlation between cardiovascular disease and diabetes mellitus: current concepts. Am J Med 2004; 116: 11-22.
Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24: 683-9.
Bonora E, Kiechi S, Willet J, Oberholienzer F, Egger G, Bonadonna RC, et al. Carotid atherosclerosis and coronary heart disease in the metabolic syndrome: Prospective data from the Bruneck study. Diabetes Care 2003; 26: 1251-7.
Okeahialam BN, Ogbonna C, Otokwula AE, Joseph DE, Chuwak EK, Isiguzoro IO. Cardiovascular Epidemiological Transition in a Rural Habitat of Nigeria: The Case of Mangu Local Government Area. West Afr J Med 2012; 31: 14-18.
Nnebue CC. The epidemiologic transition: Policy and planning implications for developing countries. Niger J Med 2010; 19(3): 250-6.
39. Omran AR. The epidemiologic transition: A theory of the epidemiology of population change. Bull World Health Organ 2001; 79: 161-70.
Araoye MO. Sample size determination. Research Methodology with Statistics for Health and Social Sciences, Ilorin, Nathadex Publishers, 2004; p.115-121.
Iloh GUP, Ikwudinma AO Abdominal obesity in adult Nigerian Africans: prevalence and co- occurrence with cardio-metabolic risk factors in a resource poor setting of a rural hospital in Eastern Nigeria. American Journal of Health Research 2013; 1: 73-80.
Iloh GUP, Amadi AN, Ikwudinma AO, Njoku PU. Prevalence and family biosocial predictors of abdominal obesity among adult Nigerian Africans in a resource constrained setting of a rural hospital in Eastern Nigeria. European Journal of Preventive Medicine 2013; 1: 70-8.
WHO. Survey of the STEPwise approach for the survellaince of risk factors for non-communicable diseases, Brazzaville, WHO, Region office for Africa, 2007.
Iloh GUP, Chuku A, Obiegbu NP, Ofoedu JN, Ikwudinma AO. Frequency of cardiovascular risk factors in adult Nigerians with family history of non-communicable cardiovascular disease in a primary care clinic of a tertiary hospital in a resource-constrained environment of Eastern Nigeria. American Journal of Health Research 2013; 1(1): 17-25.
Oladapo OO, Salako L, Sodiq O, Shoyinka K, Adedapo K, Falase AO. Prevalence of cardiometabolic risk factors among a rural Yoruba South Western Nigerian population. A population-based survey. Cardiovasc J Afr 2010; 21: 26
Dahiru T, Ejembi CL. Clustering of cardiovascular disease risk factors in semi-urban population in Northern Nigeria. Nigerian J Clin Pract 2013; 16: 511-6.
Gundogan K, Bayram F, Capak M, Tanriverdi F, Karaman A, Ozturk A. et al. Prevalence of metabolic syndrome in the Mediterranean region of Turkey: evaluation of hypertension, diabetes mellitus, obesity and dyslipidaemia. Metab Syndr Relat Disord 2009; 7: 427-34.
Vega GL. Obesity, the metabolic syndrome and cardiovascular disease. Am Heart J 2001; 142: 1108-16.
Malik S, Wong ND, Franklin SS. Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease and all causes in United States adults. Circulation 2004; 110: 1245-50.
Iloh GP, Ikwudinma AO, Obiegbu NP. Obesity and its cardio-metabolic co-morbidities among adult Nigerians in a primary care clinic of a tertiary hospital in South-Eastern Nigeria. J Fam Med Primary Care 2013; 2: 20-6
Katzmarzyk PE, Church TS, Blair SN. Cardio-respiratory fitness attenuates the effects of the metabolic syndrome on all cause and cardiovascular disease mortality in men. Arch Intern Med 2004; 164: 1092-7.
Lee IM. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 2012; 380: 219-29.
Warburton DER, Nicol CW, Bredin SSD. Health benefits of physical exercise: the evidence. CMAJ 2006; 174: 801-809.
Sobngwi E, Mbanya JC, Unwin NC. Physical activity and its relationship with obesity, hypertension and diabetes in urban and rural Cameroon. Int J Obes.Relat Metab Disord 2003; 26: 1009-16.