Prevalence of Metabolic Syndrome Among an Urban Population in Kenya

Abstract

OBJECTIVEDeveloping countries are undergoing an epidemiologic transition accompanied by increasing burden of cardiovascular disease (CVD) linked to urbanization and lifestyle modifications. Metabolic syndrome is a cluster of CVD risk factors whose extent in Kenya remains unknown. The aim of this study was to determine the prevalence of metabolic syndrome and factors associated with its occurrence among an urban population in Kenya.RESEARCH DESIGN AND METHODSThis was a household cross-sectional survey comprising 539 adults (aged ≥18 years) living in Nairobi, drawn from 30 clusters across five socioeconomic classes. Measurements included waist circumference, HDL cholesterol, triacylglycerides (TAGs), fasting glucose, and blood pressure.RESULTSThe prevalence of metabolic syndrome was 34.6% and was higher in women than in men (40.2 vs. 29%; P < 0.001). The most frequently observed features were raised blood pressure, a higher waist circumference, and low HDL cholesterol (men: 96.2, 80.8, and 80%; women: 89.8, 97.2, and 96.3%, respectively), whereas raised fasting glucose and TAGs were observed less frequently (men: 26.9 and 63.3%; women: 26.9 and 30.6%, respectively). The main factors associated with the presence of metabolic syndrome were increasing age, socioeconomic status, and education.CONCLUSIONSMetabolic syndrome is prevalent in this urban population, especially among women, but the incidence of individual factors suggests that poor glycemic control is not the major contributor. Longitudinal studies are required to establish true causes of metabolic syndrome in Kenya. The Kenyan government needs to create awareness, develop prevention strategies, and strengthen the health care system to accommodate screening and management of CVDs.

High prevalence of metabolic syndrome in the Black population of Cape Town: The Cardiovascular Risk in Black South Africans (CRIBSA) study

“…11 The higher prevalence in women than men has also been reported in several SSA countries [12][13][14]16 as well as in African-Americans. 17 However, nonAfrican-Americans 17 and other developed nations do not demonstrate a clear trend for metabolic syndrome between the sexes.…”

“…17 However, nonAfrican-Americans 17 and other developed nations do not demonstrate a clear trend for metabolic syndrome between the sexes. 12,17,18 The reason for the clear sex differences in metabolic syndrome rates in SSA and African-Americans may be related to cultural values and positive social attitudes toward fatness, 13 which contribute to the markedly higher obesity levels in women than men as found in this study (86.0% vs. 20.1%). In African cultures, being overweight is accepted and even desired as it is perceived to be associated with dignity, respect, wealth, strength, attractiveness, happiness and health, and with women being well-treated by their husbands.…”

“…13 These components were also associated with an increased prevalence of metabolic syndrome in African-American women and may reflect a sex-specific effect of overweight/obesity on glucose homeostasis, lipid profiles and atherosclerosis. 22 In men, the most frequent metabolic syndrome component in this, as well as the rural South African 11 and urban Kenyan studies, 13 was raised BP.…”

Multiple cardiovascular disease risk factors in rural Kenya: evidence from a health and demographic surveillance system using the WHO STEP-wise approach to chronic disease risk factor surveillance

“…54 The four related Kenyan studies that our search yielded were all done at Kenyatta National Hospital. 33,34,40,41 Our study population (Table 8) had prevalence of 4% high total cholesterol, 14% suboptimal HDL cholesterol, 4% high/very LDL cholesterol and < 4% high triglyceridaemia. Thus the prevalence of dyslipidaemia is much lower when compared with dysglycaemia in this rural population Our study (see Table 6) found that there was significant presence of poor blood glucose control, which rose significantly with age after 54 years, and its presence was equal in males and females.…”

“…38,39 In Nairobi, Kenya's capital city, a crosssectional survey across five socioeconomic classes reported a mean prevalence of metabolic syndrome of 35% (40% in women compared with 29% in men). 40 An autopsy study of the cardiovascular disease causes of death by the University of Nairobi reported a prevalence of 13% with the common conditions being myocardial infarction, cardiomyopathy, subarachnoid haemorrhage, pulmonary thromboembolism, ruptured aortic aneurysm and hypertensive heart disease. 41 The University of Nairobi laboratory, though a national referral hospital, still serves many Nairobi urban residents who are not national referrals.…”