Background:Waist circumference (WC) thresholds derived from western populations continue to be used in sub-Saharan Africa (SSA) despite increasing evidence of ethnic variation in the association between adiposity and cardiometabolic disease and availability of data from African populations. We aimed to derive a SSA-specific optimal WC cut-point for identifying individuals at increased cardiometabolic risk.Methods:We used individual level cross-sectional data on 24 181 participants aged ⩾15 years from 17 studies conducted between 1990 and 2014 in eight countries in SSA. Receiver operating characteristic curves were used to derive optimal WC cut-points for detecting the presence of at least two components of metabolic syndrome (MS), excluding WC.Results:The optimal WC cut-point was 81.2 cm (95% CI 78.5–83.8 cm) and 81.0 cm (95% CI 79.2–82.8 cm) for men and women, respectively, with comparable accuracy in men and women. Sensitivity was higher in women (64%, 95% CI 63–65) than in men (53%, 95% CI 51–55), and increased with the prevalence of obesity. Having WC above the derived cut-point was associated with a twofold probability of having at least two components of MS (age-adjusted odds ratio 2.6, 95% CI 2.4–2.9, for men and 2.2, 95% CI 2.0–2.3, for women).Conclusion:The optimal WC cut-point for identifying men at increased cardiometabolic risk is lower (⩾81.2 cm) than current guidelines (⩾94.0 cm) recommend, and similar to that in women in SSA. Prospective studies are needed to confirm these cut-points based on cardiometabolic outcomes.

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BackgroundTo provide a step-by-step description of the application of factor analysis and interpretation of the results based on anthropometric parameters(body mass index or BMI and waist circumferenceor WC), blood pressure(BP), lipid-lipoprotein(triglycerides and HDL-C) and glucose among Bantu Africans with different numbers and cutoffs of components of metabolic syndrome(MS).MethodsThis study was a cross-sectional, comparative, and correlational survey conducted between January and April 2005, in Kinshasa Hinterland, DRC. The clustering of cardiovascular risk factors was defined in all, MS group according to IDF(WC, BP, triglycerides, HDL-C, glucose), absence and presence of cardiometabolic risk(CDM) group(BMI,WC, BP, fasting glucose, and post-load glucose).ResultsOut of 977 participants, 17.4%( n = 170), 11%( n = 107), and 7.7%(n = 75) had type 2 diabetes mellitus(T2DM), MS, and CDM, respectively. Gender did not influence on all variables. Except BMI, levels of the rest variables were significantly higher in presence of T2DM than non-diabetics. There was a negative correlation between glucose types and BP in absence of CDM. In factor analysis for all, BP(factor 1) and triglycerides-HDL(factor 2) explained 55.4% of the total variance. In factor analysis for MS group, triglycerides-HDL-C(factor 1), BP(factor 2), and abdominal obesity-dysglycemia(factor 3) explained 75.1% of the total variance. In absence of CDM, glucose (factor 1) and obesity(factor 2) explained 48.1% of the total variance. In presence of CDM, 3 factors (factor 1 = glucose, factor 2 = BP, and factor 3 = obesity) explained 73.4% of the total variance.ConclusionThe MS pathogenesis may be more glucose-centered than abdominal obesity-centered in not considering lipid-lipoprotein , while BP and triglycerides-HDL-C could be the most strong predictors of MS in the general population. It should be specifically defined by ethnic cut-offs of waist circumference among Bantu Africans.

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Context: Polycystic ovary syndrome (PCOS) is considered a syndrome related to the metabolic syndrome with a high risk for developing diabetes mellitus. The evaluation of the glycated hemoglobin (HbA1c) seems to be an interesting tool to detect states of hyperglycemia that may be associated with this syndrome and to understand her pathophysiology. Aims: The purposes of this study are to determine the profile of HbA1c in Congolese women with PCOS, to determine the frequency of states of hyperglycemia and to assess the impact of this marker on clinical signs on this syndrome. Material and methods: This is a case-control study of 130 Congolese subfertile women; 65 with a diagnosis of PCOS and 65 others without PCOS. This is conducted from June 2016 to June 2019 among Congolese women of childbearing age.How to cite this paper:All these women were recruited at the subfertility outpatient clinic of the University Hospital of UNIKIN as well of the YANGA medical centers in Kinshasa, Democratic Republic of Congo. Sickle cell disease was excluded as also the cases of anemia. HbA1c was assayed via the immunoturbidimetric method and the results interpreted according to the ADA recommendations with a pathological cut-off point ≥ 6.5%. Results: Mean hemoglobin was 11.6 ± 1.2 g/dl (11.5 ± 1.1 g/dl vs. 11.8 ± 1.4 g/dl, P = 0.568). The proportion of diabetics was 1.6% (1.6% vs. 1.5%, P = 0.74). Higher HbA1c values were noted in the PCOS group compared to the control group (7.3% ± 2.1% vs. 5.6% ± 0.6%, P < 0.001). The multivariate analysis showed a strong correlation between elevated HbA1c levels and PCOS , P < 0.001). In the PCOS group, higher HbA1c values were significantly correlated with a higher socio-economic status ), P = 0.018) and with obesity (OR 3.48 IC (1.31 -7.13) P = 0.029). A perfect, positive and significant linear correlation was found between HbA1c and fasting blood glucose (r = 0.807). 60% of women in the PCOS group had pathological values of HbA1c (≥6.5%) compared to 7.7% in the control group (P < 0.001). Oligomenorrhea was found more significantly in patients with pathological HbA1c values (≥6.5%) compared to those with values < 6.5% (P = 0.003). Conclusion: This study found that in our population 60% of women with PCOS had states of hyperglycemia, demanding systematic screening of glucose metabolism disorders in women with this syndrome.