Prevalence and Correlates of Metabolic Syndrome Among Adults Attending Healthcare Facilities in Eastern Cape, South Africa

Abstract

Background and Aim:Urbanisation and westernisation have greatly influenced the metabolic health of individuals in South Africa, with resultant increase in metabolic syndrome (METs) components. This study aimed to determine the prevalence and factors associated with METs among adults in Buffalo City Municipality, East London, South Africa.Methods:This was a healthcare facility-based cross-sectional, descriptive study. The World Health Organisation STEPwise demographic and lifestyle behavioural questionnaire was used to collect relevant data from 998 participants. Anthropometric measurements, blood pressure and fasting blood glucose were measured using standardised protocols. Metabolic syndrome was diagnosed using the International Diabetes Federation criteria.Results:The prevalence of metabolic syndrome was 21.8%; 15.6% and 24.8% among males and females, respectively. The prevalence of METs was higher among participants who were aged 56 years and above, with low level of education (grade 1 – 7), married and retired. After adjusting for confounders, only age 26 and above (AOR=4.1, CI=2.0-8.4), marriage (AOR=2.3 CI=1.6-3.3), female sex (AOR=1.6, CI=1.1-2.4), alcohol use (AOR=2.0, CI= 1.3-3.1), unemployment (AOR=1.8, CI= 1.2-2.6) and earning an income below ZAR1200 (AOR= 1.1, CI= 1.1-2.4) were significant and independent predictors of METs. Participants aged 26 and above were four times more likely to have METs. Married non-alcohol users and unemployed participants were two times more likely to have METs than unmarried alcohol users and employed individuals.Conclusion:There was a high prevalence of metabolic syndrome among the participants which indicates a high risk for cardiovascular diseases; a leading cause of premature morbidity and mortality.

Optimal waist circumference cut-off points for predicting metabolic syndrome among low-income black South African adults

“…This could be explained by the high prevalence of obesity among women compared to men in the African societies, shaped by socio-economic and environmental variables. Given that women have higher proportion of total subcutaneous fat distribution compared to men [ 30 ], the potential risk of misclassification of women as having excessive visceral adiposity by using values of WC to predict other components of the METs [ 31 ], cannot be ignored. Conversely, Lemieux [ 32 ] and Alberti [ 33 ] reports a low WC cut-off in men compared to women, which was attributed to the notion that on average, men have twice as much visceral abdominal fat than premenopausal women [ 32 ].…”

Obesity Indices to Use for Identifying Metabolic Syndrome among Rural Adults in South Africa

“…Using STATA, (StataCorp Lp, College Station, TX, USA) the sample size required for the study was calculated based on a power of 90% and a two tailed significance level of 5%. The prevalence of MetS 21.8% amongst South African [ 4 ] with the alternative proposed proportion of 30%. A total of 345 participants were required per sample size of the study site and a total of 593 participated in the current study [ 4 ].…”

“…The prevalence of MetS 21.8% amongst South African [ 4 ] with the alternative proposed proportion of 30%. A total of 345 participants were required per sample size of the study site and a total of 593 participated in the current study [ 4 ]. The exclusion criteria included participants who were pregnant or lactating, did not fast before blood collection, with missing variables and lastly those on diabetes or hypertension medication.…”

“…According to the World Health Organisation (WHO) [ 3 ], each year, MetS accounts for 1.9 million deaths in low- and middle-income countries. In South Africa, the prevalence of MetS was stated to be 21.8%; with 15.6% being males and 24.8% females [ 4 ].…”

“…Discrepancies in the definition of MetS has been reported previously and is thought to arise from obesity indices which are considered a major risk factor [ 2 , 3 , 4 , 5 ]. Most definitions of MetS use Waist circumference (WC) as obesity index which is thought to differs by gender, ethnicity, region, population and age [ 1 , 2 , 3 , 4 , 5 ]. The joint interim statement consider gender and population in its criteria to diagnose MetS and is based on WC ≥ 94 cm for males and ≥ 80 cm for females together with other two risk factors of MetS such as hypertension, dyslipidaemia and DM2 [ 2 ].…”