Objective. To evaluate the prevalence of metabolic syndrome (MetS) according to the International Diabetes Federation (IDF) and Adult Treatment Panel (ATP) III criteria among working East African adults. Design. This cross-sectional study of 1,935 individuals (1,171 men and 764 women) was conducted among working adults in Addis Ababa, Ethiopia. The study was conducted in accordance with the STEPwise approach of the World Health Organization. Results. According to ATP III and IDF definitions, the overall prevalence of MetS was 12.5% and 17.9%, respectively. Using ATP III criteria, the prevalence of MetS was 10.0% in men and 16.2% in women. Application of the IDF criteria resulted in a MetS prevalence of 14.0% in men and 24.0% in women. The most common MetS components among women were reduced high-density lipoprotein-cholesterol (HDL-C) (23.2%) and abdominal obesity (19.6%); whilst reduced HDL-C concentrations (23.4%) and high blood pressure (21.8%) were most common among men. Conclusion. MetS and its individual components are prevalent among an apparently healthy working population in Ethiopia. These findings indicate the need for evidence-based health promotion and disease prevention programs; and more robust efforts directed towards the screening, diagnosis and management of MetS and its components among Ethiopian adults. 1. Introduction The global prevalence of chronic noncommunicable diseases (NCDs) is on the rise, with the majority of the growth occurring among populations in developing countries [1]. In sub-Saharan Africa, NCDs are projected to surpass infectious diseases by 2030 [2, 3]. Metabolic syndrome (MetS) is a constellation of risk factors of cardiovascular disease (CVD) such as diabetes and impaired glucose regulation, central obesity, hypertension, and dyslipidemia [4]. Consumption of calorie-dense foods, sedentary lifestyle, tobacco consumption, and use of antiretroviral medications are risk factors for MetS [5–10]. Limited available evidence suggests an increasing prevalence of MetS among populations in sub-Saharan African countries over the past decade [11]. Information concerning the prevalence and risk factors of MetS among sub-Saharan Africa is sparse, as most studies have been conducted in North America, Europe, and Asia [12–17]. To the best of our knowledge, no study has systematically evaluated the prevalence of MetS among Ethiopians. Currently, there are four widely used definitions for MetS, and there appears to be no consensus about the application of any one diagnostic criteria [18]. We evaluated the prevalence of MetS using
References
[1]
C. J. L. Murray and A. D. Lopez, “Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study,” Lancet, vol. 349, no. 9064, pp. 1498–1504, 1997.
[2]
C. D. Mathers and D. Loncar, “Projections of global mortality and burden of disease from 2002 to 2030,” PLoS Medicine, vol. 3, no. 11, article e442, 2006.
[3]
D. Yach, C. Hawkes, C. L. Gould, and K. J. Hofman, “The global burden of chronic diseases: overcoming impediments to prevention and control,” Journal of the American Medical Association, vol. 291, no. 21, pp. 2616–2622, 2004.
[4]
B. Lu, Y. Yang, X. Song et al., “An evaluation of the International Diabetes Federation definition of metabolic syndrome in Chinese patients older than 30 years and diagnosed with type 2 diabetes mellitus,” Metabolism, vol. 55, no. 8, pp. 1088–1096, 2006.
[5]
F. Young, J. A. Critchley, L. K. Johnstone, and N. C. Unwin, “A review of co-morbidity between infectious and chronic disease in Sub Saharan Africa: TB and diabetes mellitus, HIV and metabolic syndrome, and the impact of globalization,” Global Health, vol. 5, article 9, 2009.
[6]
M. Hanefeld, A. Ceriello, P. E. H. Schwarz, and S. R. Bornstein, “The metabolic syndrome—a postprandial disease?” Hormone and Metabolic Research, vol. 38, no. 7, pp. 435–436, 2006.
[7]
Y. Kamari, E. Grossman, M. Oron-Herman et al., “Metabolic stress with a high carbohydrate diet increases adiponectin levels,” Hormone and Metabolic Research, vol. 39, no. 5, pp. 384–388, 2007.
[8]
P. E.H. Schwarz, “Congress report from the American Diabetes Association: 66th Annual Scientific Sessions in Washington, USA,” Experimental and Clinical Endocrinology and Diabetes, vol. 114, no. 10, pp. 605–610, 2006.
[9]
E. Mutimura, N. J. Crowther, A. Stewart, and W. T. Cade, “The human immunodeficiency virus and the cardiometabolic syndrome in the developing world: an African perspective,” Journal of the cardiometabolic syndrome, vol. 3, no. 2, pp. 106–110, 2008.
[10]
World Health Organization, “World Health Report. Prevention Chronic Disease: A vital Investment,” 2008, http://www.who.int/chp/chronic_disease_report/contents/part1.pdf.
[11]
C. Kelliny, J. William, W. Riesen, F. Paccaud, and P. Bovet, “Metabolic syndrome according to different definitions in a rapidly developing country of the African region,” Cardiovascular Diabetology, vol. 7, article no. 27, 2008.
[12]
A. A. Motala, J. C. Mbanya, and K. L. Ramaiya, “Metabolic syndrome in sub-Saharan Africa,” Ethnicity & disease, vol. 19, no. 2, pp. S2–S8, 2009.
[13]
Y. Feng, X. Hong, Z. Li et al., “Prevalence of metabolic syndrome and its relation to body composition in a Chinese rural population,” Obesity, vol. 14, no. 11, pp. 2089–2098, 2006.
[14]
C. M. Y. Lee, R. R. Huxley, M. Woodward et al., “Comparisons of metabolic syndrome definitions in four populations of the Asia-Pacific region,” Metabolic Syndrome and Related Disorders, vol. 6, no. 1, pp. 37–46, 2008.
[15]
E. S. Ford, “Prevalence of the metabolic syndrome defined by the international diabetes federation among adults in the U.S,” Diabetes Care, vol. 28, no. 11, pp. 2745–2749, 2005.
[16]
K. Shiwaku, A. Nogi, K. Kitajima et al., “Prevalence of the metabolic syndrome using the modified ATP III definitions for workers in Japan, Korea and Mongolia,” Journal of Occupational Health, vol. 47, no. 2, pp. 126–135, 2005.
[17]
E. S. Ford, W. H. Giles, and W. H. Dietz, “Prevalence of the metabolic syndrome among US adults: findings from the Third National Health and Nutrition Examination Survey,” Journal of the American Medical Association, vol. 287, no. 3, pp. 356–359, 2002.
[18]
K. G. M. M. Alberti and P. Z. Zimmet, “Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation,” Diabetic Medicine, vol. 15, no. 7, pp. 539–553, 1998.
[19]
S. M. Grundy, J. I. Cleeman, S. R. Daniels et al., “Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement,” Circulation, vol. 112, no. 17, pp. 2735–2752, 2005.
[20]
K. G. M. M. Alberti, P. Zimmet, and J. Shaw, “The metabolic syndrome—a new worldwide definition,” Lancet, vol. 366, no. 9491, pp. 1059–1062, 2005.
[21]
A. E. Schutte, R. Schutte, H. W. Huisman et al., “Classifying Africans with the metabolic syndrome,” Hormone and Metabolic Research, vol. 41, no. 2, pp. 79–85, 2009.
[22]
World Health Organization, “Chronic diseases and health promotion: Stepwise approach to surveillance (STEPS),” 2010, http://www.who.int/chp/steps/manual/en/index.html.
[23]
T. Colton, Statistics in Medicine, Little Brown, Boston, Mass, USA, 1974.
[24]
W. Getahun, T. Gedif, and F. Tesfaye, “Regular Khat (Catha edulis) chewing is associated with elevated diastolic blood pressure among adults in Butajira, Ethiopia: a comparative study,” BMC Public Health, p. 390, 2010.
[25]
A. V. Chobanian, G. L. Bakris, H. R. Black et al., “Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure,” Hypertension, vol. 42, no. 6, pp. 1206–1252, 2003.
[26]
L. Fezeu, B. Balkau, A. P. Kengne, E. Sobngwi, and J. C. Mbanya, “Metabolic syndrome in a sub-Saharan African setting: central obesity may be the key determinant,” Atherosclerosis, vol. 193, no. 1, pp. 70–76, 2007.
[27]
I. I. Ulasi, C. K. Ijoma, and O. D. Onodugo, “A community-based study of hypertension and cardio-metabolic syndrome in semi-urban and rural communities in Nigeria,” BMC Health Services Research, vol. 10, article no. 71, 2010.
[28]
M. A. Njelekela, R. Mpembeni, A. Muhihi et al., “Gender-related differences in the prevalence of cardiovascular disease risk factors and their correlates in urban Tanzania,” BMC Cardiovascular Disorders, vol. 9, article 30, 2009.
[29]
O. A. Adegoke, R. A. Adedoyin, M. O. Balogun, R. A. Adebayo, L. A. Bisiriyu, and A. A. Salawu, “Prevalence of metabolic syndrome in a rural community in Nigeria,” Metabolic Syndrome and Related Disorders, vol. 8, no. 1, pp. 59–62, 2010.
[30]
A. C. Santos and H. Barros, “Impact of metabolic syndrome definitions on prevalence estimates: a study in a Portuguese community,” Diabetes and Vascular Disease Research, vol. 4, no. 4, pp. 320–327, 2007.
[31]
A. S. Can and T. P. Bersot, “Analysis of agreement among definitions of metabolic syndrome in nondiabetic Turkish adults: a methodological study,” BMC Public Health, vol. 7, article no. 353, 2007.
[32]
R. Sodjinou, V. Agueh, B. Fayomi, and H. Delisle, “Obesity and cardio-metabolic risk factors in urban adults of Benin: relationship with socio-economic status, urbanisation, and lifestyle patterns,” BMC Public Health, vol. 8, article 84, 2008.
[33]
O. O. Oladapo, L. Salako, O. Sodiq, K. Shoyinka, K. Adedapo, and A. O. Falase, “A prevalence of cardiometabolic risk factors among a rural Yoruba south-western Nigerian population: a population-based survey,” Cardiovascular Journal of Africa, vol. 21, no. 1, pp. 26–31, 2010.
[34]
F. Tesfaye, P. Byass, and S. Wall, “Populationbased prevalence of high blood pressure among adults in Addis Ababa: uncovering a silent epidemic,” BMC Cardiovascular Disorders, vol. 9, article no. 39, 2009.
[35]
F. Tesfaye, N. G. Nawi, H. Van Minh et al., “Association between body mass index and blood pressure across three populations in Africa and Asia,” Journal of Human Hypertension, vol. 21, no. 1, pp. 28–37, 2007.
[36]
F. Tesfaye, P. Byass, S. Wall, Y. Berhane, and R. Bonita, “Association of smoking and khat (Catha edulis Forsk) use with high blood pressure among adults in Addis Ababa, Ethiopia, 2006,” Preventing Chronic Disease, vol. 5, no. 3, article A89, 2008.
[37]
S. Kadiri and B. L. Salako, “Cardiovascular risk factors in middle aged Nigerians,” East African Medical Journal, vol. 74, no. 5, pp. 303–306, 1997.
[38]
R. BeLue, TA Okoror, J Iwelunmor, et al., “An overview of cardiovascular risk factor burden in sub-Saharan African countries: a socio-cultural perspective,” Global Health, vol. 5, article 10, 2009.
[39]
L. Fezeu, E. Minkoulou, B. Balkau et al., “Association between socioeconomic status and adiposity in urban Cameroon,” International Journal of Epidemiology, vol. 35, no. 1, pp. 105–111, 2006.
[40]
K. S. Reddy and S. Yusuf, “Emerging epidemic of cardiovascular disease in developing countries,” Circulation, vol. 97, no. 6, pp. 596–601, 1998.
[41]
H. C. Onyegbutulem, P. I. H-Onyegbutulem, M. Reimann, J. Li, S. R. Bornstein, and P. E. Schwarz, “Metabolic syndrome in Africa: an emerging perspective,” Hormone and Metabolic Research, vol. 41, no. 2, pp. 75–78, 2009.
[42]
D. Kebede, A. Alem, G. Mitike et al., “Khat and alcohol use and risky sex behaviour among in-school and out-of-school youth in Ethiopia,” BMC Public Health, vol. 5, article no. 109, 2005.
[43]
BO. Isomaa, P. Almgren, T. Tuomi et al., “Cardiovascular morbidity and mortality associated with the metabolic syndrome,” Diabetes Care, vol. 24, no. 4, pp. 683–689, 2001.
