Frequency and Sex-Specific Associations of Metabolic Syndrome in Rwandans Seeking Outpatient Care: A Cross Sectional, Single Centre Study

Abstract

James Gafirita,1,* Cuthbert Musarurwa,1,* Evariste Ntaganda,2,* Marguerite Uwimana,3,* Aime Dieudonne Hirwa,4,* Mediatrice Mukahigiro,5,* Laetitia Twizelimana,6,* Marie Louise Nshimirimana,6,* Stephen Rulisa,7,8 Charlotte Bavuma,8,9,* Emile Ivan,10 David K Tumusiime11,* 1Department of Biomedical Laboratory Sciences College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda; 2Division of Non-Communicable Diseases, Rwanda Biomedical Center (RBC), Ministry of Health, Kigali, Rwanda; 3Department of NCD, Ruhengeri Provincial Hospital, Musanze, Northern Province, Rwanda; 4Department of Surgery, Ruhengeri Provincial Hospital, Musanze, Northern Province, Rwanda; 5Department of Laboratory Diagnosis, Ruhengeri Provincial Hospital, Musanze, Northern Province, Rwanda; 6Department of Internal Medicine, Ruhengeri Provincial Hospital, Musanze, Northern Province, Rwanda; 7Department of Obstetrics and Gynecology, Kigali University Teaching Hospital, Kigali, Rwanda; 8Department of Obstetrics and Gynecology School of Medicine and Pharmacy, College of Medicine and Health Science, University of Rwanda, Kigali, Rwanda; 9Department of Internal Medicine, Kigali University Teaching Hospital, Kigali, Rwanda; 10Department of Drugs Assessment and Registration, Division of Human Medicine and Device Registration, Rwanda Food and Drugs Authority, Kigali, Rwanda; 11Department of Physiotherapy School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda*These authors contributed equally to this workCorrespondence: James Gafirita, Email [email protected]: The prevalence of cardiometabolic diseases is escalating in sub-Saharan Africa (SSA) alongside the prevailing high burden of communicable diseases. Although many countries in SSA, including Rwanda, have existing data on the prevalence of individual components of the MetS, many SSA countries have insufficient data to guide policy makers on the magnitude of MetS. This study sought to determine the magnitude of MetS and its associated risk factors by sex at a referral teaching hospital in Rwanda.Methods: A cross-sectional, study was conducted among adults aged 35 to 65 years presenting at Ruhengeri Referral Teaching Hospital, Rwanda. We collected socio-clinicodemographic data using the World Health Organization (WHO) STEPwise tool for non-communicable diseases. We used the National Cholesterol Education Program Adult Treatment Panel III criteria for MetS.Results: Overall, 99 (23.5%) males and 322 (76.5%) female participants with mean ± SD age 47.5 ± 8.2 years were enrolled. The overall frequency of MetS was 51.9% (95% CI: 47.0– 56.8) and was significantly higher (p < 0.001) in females 193 (59.4%) compared to males 26 (26.3%). Significant differences by sex were also noted in the proportions of visceral obesity; 70.4% vs 7.1% (p < 0.001), hypoalphalipoproteinaemia 36.1% vs 69.7% (p < 0.0001), type 2 diabetes mellitus; 18.4% vs 31.6% (p = 0.020) and body mass index 25.9 ± 15.6 vs 28.2 ± 6.4 (p = 0.032). On multivariate logistic regression, older age (odds ratio (OR) 1.05; 95% confidence interval ((CI) 1.01– 1.10)), higher body weight (OR 1.06; 95% CI 1.04– 1.08) and higher total cholesterol (1.25; 95% CI 1.05 − 1.74) were significantly associated with MetS in females; whereas only higher body weight (OR1.10; 95% CI 1.04– 1.18) was significantly associated with MetS in males.Conclusion: A high frequency of MetS was observed in the present study, which was higher among females. Our findings emphasize the need for tailored prevention and intervention strategies to mitigate the long-term impact of MetS.Keywords: frequency, metabolic syndrome, non-communicable diseases, Rwanda

Keywords

• frequency
• metabolic syndrome
• non-communicable diseases
• rwanda