High risk of metabolic syndrome among black South African women with severe mental illness

Abstract

BackgroundThere is an increased prevalence of metabolic syndrome (MetS) in individuals with severe mental illness (SMI) globally. The prevalence of MetS is higher in black women compared to black men from South Africa.AimTo compare the prevalence of MetS between black South African men and women with SMI taking antipsychotic medication. Further, this prevalence was compared to the prevalence in a matched control group of black South African men and women without SMI.SettingA general hospital psychiatric unit.MethodsA cross-sectional study was undertaken to compare the prevalence of MetS in a group of multi-ethnic participants with SMI treated with antipsychotic medication and a matched control group without SMI, applying the 2009 Joint Interim Statement (JIS) criteria. Here, we included only the black African participants to compare MetS prevalence between men and women.ResultsThere were 232 participants in the group with SMI (male 155 and female 77) and without SMI (male 156 and female 76). The prevalence of MetS was more than three times higher in women with SMI compared to men with SMI (37.7% vs. 10.3%, p < 0.001). There was no significant difference in the prevalence of MetS in men or women between the groups with and without SMI. In multivariate logistic regression analysis, female gender (odds ratio [OR] 7.66), advancing age (OR 1.08) and longer duration of illness (OR = 1.15) were significant risk factors for MetS in SMI.ConclusionIn black South Africans with SMI on antipsychotic medication, there is a higher prevalence and risk for MetS in women compared to men.

Prevalence of metabolic syndrome and its associated risk factors in an African–Caribbean population with severe mental illness

“…Nevertheless, our study and the above-mentioned studies are inconsistent with previous meta-analyses, reporting no gender differences in MetS prevalence (Mitchell et al, 2013b;Vancampfort et al, 2015). The higher MetS prevalence in female patients could be explained by the greater propensity for obesity in African-Caribbean and African women (McEvoy et al, 2005;Saloojee et al, 2016Saloojee et al, , 2017. Although it is known that obesity is related to poor health outcomes, in African and African-Caribbean populations this notion may interfere with the sociocultural conception of beauty and social acceptance toward overweight in women (Chithambo and Huey, 2013;Grol et al, 1997;Hoek et al, 2005).…”

“…Our results are consistent with the findings from the African-American subsample of the CATIE study, South African studies and a Ghanaian study demonstrating a significant gender disparity in the prevalence of MetS (McEvoy et al, 2005;Owusu-Ansah et al, 2018;Saloojee et al, 2017Saloojee et al, , 2016. Saloojee et al (2016) found a higher MetS prevalence in South African female patients (38.3%) than in the male patients (15.4%, p < .001).…”

Prevalence and correlates of metabolic syndrome and its components in adults with psychotic disorders in Eldoret, Kenya

“…In the current study metabolic syndrome was associated with psychosis and increasing age. Of note is that males were more likely to have metabolic syndrome than females; findings that differ from those reported in a South African study where the prevalence of metabolic syndrome among black African women were more than three times more compared to men in the same setting [The South African study was similar to the Kenyan study in terms of age—both a mean age less than 40 in both and obesity rates around 45%] [ 27 ]. The lower rates of metabolic syndrome among females in our setting is may be attributed to other factors such as genetics, and environmental factors [ 28 , 29 ] which may be difficult to explain in entirety at this point but warrant further investigation.…”

Metabolic syndrome among people with mental illness in sub Saharan Africa: Female gender as a factor. A Systematic review and meta-analysis

“…All the included nine studies were cross sectional studies in their design. These studies were conducted across different countries of sub-Saharan Africa (two primary articles from Ethiopia [ 16 , 17 ], three from South Africa [ [18] , [19] , [20] ], two studies from Nigeria [ 21 , 22 ] and the rest two were from Ghana [ 23 ] and Uganda [ 24 ]. The sample size of primary studies included in this review was considerably variable ranging 88 to 450 participants ( Table 2 ).…”