Metabolic syndrome more likely in Africans living a U.S.-type lifestyle

Native Africans with type 2 diabetes had increased risk in the presence of demographic and clinical factors.

The development of metabolic syndrome in native Africans with type 2 diabetes is influenced by similar demographic and clinical factors observed in patients with metabolic syndrome in the United States.

“Given suitable environmental factors, such as physical inactivity and an affluent diet, genetically predisposed indigenous Africans would develop metabolic syndrome. They could therefore become potentially susceptible to atherosclerotic heart disease that had hitherto been a rarity,” Simeon Alabi Isezuo, MBBS, told Cardiology Today.

Isezuo, consultant cardiologist and senior lecturer at Usmanu Dandodiyo University Teaching Hospital in Nigeria, was an author on a recent paper published in the Journal of the National Medical Association.

Researchers had consecutively recruited 254 indigenous Nigerians with type 2 diabetes. They performed a cross-sectional analysis that included the following variables to determine which had the greatest impact on the presence of metabolic syndrome: family history, duration of diabetes mellitus and hypertension, gender, socioeconomic class, occupation, and place of domicile (urban or rural).

Metabolic factors

Mean age of the patient cohort was 52 years, and 60.6% of the patients were men. According to the research abstract, full-blown metabolic syndrome was noted in 20.5% of patients. Metabolic syndrome defined by the World Health Organization criteria was present in 59.1% of patients.

No effect on metabolic syndrome was noted related to the variables of age, duration of diabetes mellitus, fasting blood sugar, HDL cholesterol, total cholesterol, gender, literacy, cigarette smoking, or dyslipidemia.

However, those defined as upper or middle class were more likely to have metabolic syndrome (52%). Urban dwellers were also more likely to have metabolic syndrome than not (68% vs. 49%).

Those with a positive family history of diabetes mellitus and/or high blood pressure were also more likely to have metabolic syndrome (44%) than to not have metabolic syndrome.

If patients had concurrent diabetes mellitus and high blood pressure they were much more likely to have metabolic syndrome (74.7%).

Obese patients were also much more likely to have metabolic syndrome (69.3%).

Finally, presence of hyperuricemia and albuminuria was associated with the presence of metabolic syndrome.

Avoiding metabolic syndrome

Isezuo said that to avoid metabolic syndrome, he recommends a native African lifestyle characterized by a high degree of physical activity and a fiber diet. Furthermore, the awareness of metabolic cardiovascular risk factors among diabetic patients could be increased among clinicians through continuing education and the promotion of research.

“For the general population, a long-term increase in awareness could be increased through improved literacy status. The print and electronic media are effective tools for informing and educating the populace about type 2 diabetes and metabolic syndrome,” Isezuo said. – by Jeremy Moore

For more information:

• Isezuo SA, Ezunu E. Demographic and clinical correlates of metabolic syndrome in native African type 2 diabetic patients. J Natl Med Assoc. 2005;97:557-563.