Aging, female sex, migration, elevated HDL-C, and inflammation are associated with prevalence of metabolic syndrome among African bank employees

Abstract

Thierry Gombet,1 Benjamin Longo-Mbenza,2 Bertrand Ellenga-Mbolla,1 Meo Stephane Ikama,3 Etienne Mokondjimobe,4 Gisele Kimbally-Kaky,3 Jean-Louis Nkoua,31Emergency Department, University Hospital Center of Brazzaville, Brazzaville, Congo; 2Faculty of Health Sciences, Walter Sisulu University, Mthatha, Eastern Cape, South Africa; 3Department of Cardiology and Internal Medicine, University Hospital Center of Brazzaville, Brazzaville, Congo; 4Laboratory of Biochemistry and Pharmacology, Faculty of Health Sciences, Brazzaville, CongoBackground: The objective of this study was to compare four different criteria for diagnosing metabolic syndrome (MS) and to correlate sociodemographic data, liver enzymes, lipids, inflammation, and insulin resistance with MS definitions.Methods: This cross-sectional study included a random number of 126 African bank employees from Brazzaville, Congo.Results: The prevalence of MS varied according to the different definitions used: 4.8% under World Health Organization (WHO) criteria, 8.7% under the National Cholesterol Education Program Adult Treatment Panel III (NECP-ATPIII) criteria, 14.3% under the International Diabetes Federation (IDF) for Europe, and 15.9% by the IDF for Central Africa. According to the IDF, specific cutoff points for the erythrocyte sedimentation rate, ≥13 mm at first hour and ≥30 mm at second hour, defined MS for Central Africa. The best agreement was observed between the IDF for Europe and the IDF for Central Africa (Kappa = 0.938; P < 0.0001) criteria. The worst agreements were between the WHO and IDF for Central Africa (Kappa = 0.419; P < 0.0001) criteria and between the WHO and IDF for Europe (Kappa = 0.462; P < 0.0001) criteria. The NECP-ATPIII criteria did not agree with either the IDF for Europe or the IDF for Central Africa criteria. There was a significant relationship between female sex, aging, elevated liver enzymes, elevated phospholipids, high homeostasis model assessment of insulin resistance, and MS defined by the IDF for Central Africa.Conclusion: The IDF definition of the MS modified for Central Africa provides higher prevalence estimates of MS than the estimates based on the NECP-ATPIII and IDF for Europe criteria. Liver enzymes, phospholipids, and homeostasis model assessment of insulin resistance should be included in clinical practice to stratify cardiovascular disease risk among Africans.Keywords: metabolic syndrome, insulin resistance, inflammation, liver enzymes, atherosclerosis, sub-Saharan Africa