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.

Background: Triglyceride-glucose (TyG) index, a product of triglyceride and fasting plasma glucose, is a novel tool that can identify people with metabolic syndrome (MS). It is unknown if TyG index can identify MS among Nigerians. Methods: Cross-sectional health screening conducted between August and December 2018, among staff and students of Ekiti State University/Ekiti State University Teaching Hospital, Nigeria, Ado-Ekiti. The analysis included 473 participants, aged ≥18 years. Anthropometric indices and blood pressure were measured by standard protocol. Fasting lipid profile and blood glucose were determined. TyG index and product of TyG and anthropometric indices were calculated, and MS defined according to the harmonized criteria. The diagnostic ability of TyG index and related parameters to identify people with MS was determined with the area under curve (AUC) of receiver operating characteristic curves. Stepwise logistic regression analyses were used to generate odd ratios (ORs) for prediction of MS. Results: The mean age of the participants was 39.2 (11.4) years and there were 173 (36.6%) men. In all participants, TyG-waist to height ratio (TyG-WHtR) shows the largest AUC for MS detection (0.863, 95% confidence interval, CI: 0.828–0.892) followed by TyG-waist circumference (TyG-WC) (0.858, 95% CI: 0.823–0.888), TyG-body mass index (TyG-BMI) (0.838, 95% CI: 0.802–0.870), TyG index (0.796, 95% CI: 0.757–0.831), WHtR (0.791, 95% CI: 0.752–0.827), and TyG-waist-to-hip ratio (TyG-WHpR) (0.771, 95% CI: 0.730–0.808) in that order. Gender analysis revealed that TyG-WC and TyG-WHtR have largest AUC in both genders. Before and after adjustment, TyG-WHtR (OR: 6.86, 95% CI: 3.94–11.93) and TyG index (OR: 5.91, 95% CI: 3.01–11.59) presented the highest OR in all participants, respectively. Conclusions: TyG index is effective in identifying MS in this cross-sectional study, and the product of TyG index and anthropometric indices improved identification and prediction of MS.

Obesity and overweight are common in our urban dwellers with accompanying regional differences. Attainment of middle age increases the likelihood of urban dwelling Nigerians to become overweight/obese. There is therefore the need to institute measures that will check development of overweight/obesity early enough, while improving the nutritional status of the few who may still be undernourished.

Introduction mobile phone technology is increasingly used to overcome traditional barriers to limiting access to diabetes care. This study evaluated mobile phone ownership and willingness to receive and pay for mobile phone-based diabetic services among people with diabetes in South-West, Nigeria. Methods two hundred and fifty nine patients with diabetes were consecutively recruited from three tertiary health institutions in South-West, Nigeria. Questionnaire was used to evaluate mobile phone ownership, willingness to receive and pay for mobile phone-based diabetic health care services via voice call and text messaging. Results 97.3% owned a mobile phone, with 38.9% and 61.1% owning smartphone and basic phone respectively. Males were significantly more willing to receive mobile-phone-based health services than females (81.1% vs 68.1%, p=0.025), likewise married compared to unmarried [77.4% vs 57.1%, p=0.036]. Voice calls (41.3%) and text messages (32.4%), were the most preferred modes of receiving diabetes-related health education with social media (3.1%) and email (1.5%) least. Almost three-quarter of participants (72.6%) who owned mobile phone, were willing to receive mobile phone-based diabetes health services. The educational status of patients (adjusted OR [AOR]: 1.7{95% CI: 1.6 to 2.1}), glucometers possession (AOR: 2.0 [95% CI: 1.9 to 2.1) and type of mobile phone owned (AOR: 2.9 [95% CI: 2.8 to 5.0]) were significantly associated with the willingness to receive mobile phone-based diabetic services. Conclusion the majority of study participants owned mobile phones and would be willing to receive and pay for diabetes-related healthcare delivery services provided the cost is minimal and affordable.

Objective:The study assessed the risk of developing type 2 diabetes Mellitus in Ogun State, Nigeria.Materials and Methods:Finnish Medical Association diabetes risk score was administered across 25 communities facilitated by non-communicable disease clinics established under a World Diabetes Foundation project. Subjects in the high risk group had blood glucose estimated.Results:58,567 respondents included 34,990 (59.6%) females and 23,667 (40.3%) males. Majority (61.2%) were between 25 years and 54 years. Considering waist circumference, 34,990 (38.1%) females and 23,667 (5.3%) males had values above 88 cm and 102 cm respectively. Overall, 11,266 (19.2%) were obese and 28.9% overweight using body mass index (BMI). More females had elevated BMI than males. Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of all subjects were 129.54 mm Hg ± 23.5 mm Hg and 76.21 mm Hg ± 15.5 mm Hg respectively. Prevalence of hypertension (Joint National Committee VII classification) was 27.7%. More subjects had normal DBP than SBP (68.2% vs. 42.5% P < 0.05). Mean fasting blood glucose (FBG) of all subjects was 5.5 mmol/L ± 0.67 mmol/L. Using a casual blood glucose >11.1 mmol/L and/or FBG >7 mmol/L, the total yield of subjects adjudged as having diabetes was 2,956 (5.05%). Mean total risk score was 5.60 ± 3.90; this was significantly higher in females (6.34 ± 4.16 vs. 4.24 ± 3.71, P < 0.05). A total of 2,956 (5.05%) had high risk of developing DM within 10 years.Conclusion:The risk of developing DM is high in the community studied with females having a higher risk score. There is urgent need to implement diabetes prevention strategies.

Background:Waist circumference (WC) is a simple tool for measuring central obesity in routine clinic settings. Gender- and ethnic-specific optimal cutoff points for WC are encouraged for populations lacking such data.Objectives:To derive WC cutoff values, predictive of overweight and obesity in Nigerians and to evaluate the performance of currently recommended values.Subjects and Methods:Apparently, healthy urban dwellers from six cities spread across Nigeria were selected for this cross-sectional study. Biophysical profiles such as blood pressure and anthropometric indices were measured according to the World Health Organization's STEPs instrument protocol. Receiver operating characteristics curve analysis was used to determine the optimal cutoff levels using the decision rule of maximum (sensitivity + specificity). The level of significance was set at P < 0.05.Results:A total of 6089 subjects (3234 males and 2855 females) were recruited for the study. WC demonstrated a high area under the curve in both genders. Selected cutoff points ranged from 83 to 96 cm with high sensitivities and specificities.Conclusions:The currently recommended gender-specific WC cutoff values proved inappropriate in this study group, but WC remains a reliable tool for measuring obesity.

Background:The prevalence of metabolic syndrome varies by the definition used and the population studied. In order to make comparison among various studies possible, a new criterion which harmonizes the previous definitions was proposed. This study aims to determine the prevalence of metabolic syndrome with the harmonized criteria, and its concordance with the International Diabetes Federation (IDF), and National Cholesterol Education Programme-Adult Treatment Panel (NCEP-ATP III) criteria. Methods: One hundred and two apparently healthy individuals who participated in health screening were evaluated for metabolic syndrome. The blood pressure and anthropometric parameters were measured according to standard protocol, and fasting plasma glucose and lipid profile were determined. Metabolic syndrome was defined using the Harmonized, IDF and ATP III criteria. The agreement among the three diagnostic criteria was determined with kappa statistics. Results: The prevalence of metabolic syndrome was 4.9%, 3.9% and 4.9% with harmonized, IDF, and NCEP-ATP criteria respectively. Compared to the males, the prevalence was greater in females: Males vs Females (harmonized, 2.2% vs 7.0%; IDF, 2.2% vs 5.3%; NCEP-ATP III, 2.2% vs 7.0%). The commonest risk factor in this population was low HDL occurring in 93.0% and 37.8% of females and males respectively, followed by central obesity (50.9% in females, 13.3% in males with harmonized and IDF criteria; 33.3% in females, 4.4% in males with NCEP-ATP criteria), hypertension (12.5% in females, 18.6% in males) and hyperglycaemia (4.2% in females, 0.0% in males) in that order. None of the participants had elevated Triglyceride. There was a substantial concordance between the harmonized and the IDF (k=0.884) as well as the harmonized and NCEP-ATP III (k=1.000) definitions. Conclusion: The prevalence of metabolic syndrome was low in this population. There was a substantial agreement among the three diagnostic criteria.

Background: The heightened cardiovascular risk associated with metabolic syndrome (MetS) has been documented by several researchers. The Framingham risk score (FRS) provides a simple and efficient method for identifying individuals at cardiovascular risk. The objective was to describe the prevalence of MetS and its association with FRS in predicting cardiovascular disease among a cohort of semi-urban women; Method: Clinical and laboratory parameters were evaluated among 189 healthy women. The International Diabetes Federation definition was used to diagnose metabolic syndrome. FRS was calculated for each participant; Result: About two thirds of the participant make less than $US 90 per month. The mean systolic blood pressure was 131.80 ± 30. Eighty (42.3%) participants were overweight with a mean waist circumference of 91.64 ± 11.19 cm. MetS was present in 46 (24.3%). Individuals with MetS were more likely to have increased FRS, p = 0.012. One hundred and eighty seven (98.9%) were in the low risk category according to FRS. There was a significant difference in the mean FRS between participants with and without MetS (13.52 versus 10.29 p = 0.025); Conclusion: Prevalence of MetS in this study was comparable to the global rate, despite a low economic status. Individuals with MetS were more likely to have cardiovascular disease than persons without MetS, thus emphasizing the need for risk stratification and prompt management.