Metabolic syndrome and its predictors in an urban population in Kenya: A cross sectional study

Abstract

BackgroundThe metabolic syndrome (MetS) is a clustering of interrelated risk factors which doubles the risk of cardio-vascular disease (CVD) in 5–10 years and increases the risk of type 2 diabetes 5 fold. The identification of modifiable CVD risk factors and predictors of MetS in an otherwise healthy population is necessary in order to identify individuals who may benefit from early interventions. We sought to determine the prevalence of MetS as defined by the harmonized criteria and its predictors in subjectively healthy black Africans from various urban centres in Kenya.MethodWe used data collected from healthy black Africans in Kenya as part of a global study on establishing reference intervals for common laboratory tests. We determined the prevalence of MetS and its components using the 2009 harmonized criterion. Receiver operator characteristic (ROC) curve analysis was used to determine the area under the curves (AUC) for various predictors of MetS. Youden index was used to determine optimum cut-offs for quantitative measurements such as waist circumference (WC).ResultsA total of 528 participants were included in the analysis. The prevalence of MetS was 25.6% (95% CI: 22.0%–29.5%). Among the surrogate markers of visceral adiposity, lipid accumulation product was the best predictor of MetS with an AUC of 0.880 while triglyceride was the best predictor among the lipid parameters with an AUC of 0.816 for all participants. The optimal WC cut-off for diagnosing MetS was 94 cm and 86 cm respectively for males and females.ConclusionsThe prevalence of MetS was high for a healthy population highlighting the fact that one can be physically healthy but have metabolic derangements indicative of an increased CVD risk. This is likely to result in an increase in the cases of CVD and type 2 diabetes in Kenya if interventions are not put in place to reverse this trend. We have also demonstrated the inappropriateness of the WC cut-off of 80 cm for black African women in Kenya when defining MetS and recommend adoption of 86 cm.

<p>Obesity Indices for Identifying Metabolic Syndrome Among Type Two Diabetes Patients Attending Their Follow-Up in Dessie Referral Hospital, North east Ethiopia</p>

“…Furthermore, the current optimal cut-offs were lower compared to studies done in north Iran (91 cm in women and 90 cm in men), Jordan (95.6 cm women and 97.8 cm for men), and Kenya (85.5 cm for women and 93.5 cm for men). 20,28,29 This implies that the adoption of the European cut point may not be appropriate for this community.…”

“…19 Where N = sample size, d= margin of error, V(AUC) = variance of area under the curve, and Z a/2 = the value under the standard normal table for a given value of confidence level. By taking AUC of 0.83 for WC from a study done in Kenya, 20 power of 80%, confidence interval of 95%, margin of error of 5% and 10% for non-response rate, the calculated sample size was 363. The study participants were taken consecutively until the required sample size was obtained.…”

Erratum to: Metabolic syndrome and its predictors in an urban population in Kenya: a cross sectional study

“…The original article [1] was updated to correct a mistake in the third sentence of the conclusions section: ‘There is also a need to adopt gender specific MetS TG cut-offs to avoid over diagnosing hypertriglyceridaemia in black African women who have a lower TG level compared to the 1.7 mmol/L cut-off.’ …”

Lipid accumulation product or lap as an up-to-date clinical biochemical marker of human obesity

“…Among population studies, the greatest LAP index variations were detected among Iran population (from 0.62 to 570.26 cm.mmol/l in men (n=3,682) and from 0.56 to 620.39 cm.mmol/l in women (n=4,989)) [42]. Significant variations in LAP index values were also detected among people living in Kenya (from 0 to 388.87 cm.mmol/l in men (n=255) and from 3.30 до 205.54 cm.mmol/l in women (n=273)) [43]; among elderly males in Poland (aged 50-75, n=313) (from 7.36 to 338.97 cm.mmol/l) [19]; and among young women (younger than 40, n=2,810) in Korea (from 0 to 252.0 cm.mmol/l) [44]. However, a significantly wider range of LAP index variations is detected when it comes to patients with cardiovascular pathologies (0.8-1,020 cm.mmol/l in men (n=3,604) and 0.7-1,020 cm.mmol/l in women (n=2,320) respectively) [41].…”

“…According to some research, LAP index values tend to be higher in men than in women [29,33], whereas other studies, on the contrary, contain data on higher LAP index values to be more typical for women [45,46] (Table 1). Some authors state there are no age-related differences in LAP index values [13,43].…”