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孕期代谢综合征:喀麦隆西部地区丹尚区医院随访的孕妇中的患病率及决定因素

Metabolic Syndrome During Pregnancy: Prevalence and Determinants Among Pregnant Women Followed-Up at the Dschang District Hospital, West Region of Cameroon.

作者信息

Dabou Solange, Ongbayokolak Nadine Sylvie, Fonkeng Sama Leonard, Matene Foking Emerveline, Kamdom Nadine Mélaine, Telefo Phélix Bruno

机构信息

Department of Biochemistry, University of Dschang, Dschang, Cameroon.

Department of Biomedical Analyses, Dschang District Hospital, Dschang, Cameroon.

出版信息

Diabetes Metab Syndr Obes. 2022 Mar 5;15:743-753. doi: 10.2147/DMSO.S348040. eCollection 2022.

Abstract

PURPOSE

Metabolic syndrome (MS) during pregnancy constitutes a serious threat to the mother and child health that will shortly become a major public health issue, especially in developing countries. However, in Cameroon, epidemiological data on MS during pregnancy are still scarce. The aim of this study was to determine the prevalence and determinants of MS among pregnant women followed-up at the Dschang District Hospital (DDH), in the west region of Cameroon.

PATIENTS AND METHODS

This study was a hospital based cross-sectional study, carried out among pregnant women followed-up at the antenatal care unit of the DDH, from September 2019 to June 2020. Participants were assessed on sociodemographic, lifestyle parameters, and dietary habits using standardized and structured questionnaires. Anthropometric parameters, blood pressure, and biochemical markers were measured using standard procedures. Metabolic syndrome was diagnosed using the HNLBI/AHA definition, modified for pregnant women by Chatzi et al. A participant was recorded as having MS if presenting at least three of the following criteria: Pre-gestational BMI >30 kg/m2; triglycerides ≥150 mg/dl; HDL cholesterol <50 mg/dl; SBP ≥130/DBP ≥85 mm/Hg; and fasting blood glucose ≥100 mg/dl.

RESULTS

Six hundred and four (604) pregnant women were included in the study. The prevalence of MS was 17.88% (95% CI: 15.03-21.14) and its most frequent individual components were low levels of HDL-cholesterol (66.23% (95% CI: 62.36-69.88)) and hypertriglyceridemia (28% (95% CI: 54.31-62.15)). Grand multiparous shows a higher risk of presenting MS (OR:3.06, 95% CI: 1.24-7.12; p = 0.011) compared to nulliparous. Pregestational BMI appears to be the best predictor of MS during pregnancy even after adjustment on age, parity, lifestyle and dietary habits (OR: 46.46, 95% CI: 15.58-138.49; ˂ 0.0001).

CONCLUSION

The prevalence of MS on pregnant women in the Dschang health district is 17.88% (95% CI: 15.03-21.14) and its major determinant is pre-gestational obesity. This work provides quality preliminary data for the design and improvement of prevention strategies.

摘要

目的

孕期代谢综合征(MS)对母婴健康构成严重威胁,很快将成为一个重大的公共卫生问题,尤其是在发展中国家。然而,在喀麦隆,关于孕期MS的流行病学数据仍然匮乏。本研究的目的是确定喀麦隆西部地区雅温得区医院(DDH)随访的孕妇中MS的患病率及其决定因素。

患者与方法

本研究是一项基于医院的横断面研究,于2019年9月至2020年6月在DDH产前护理单元随访的孕妇中进行。使用标准化和结构化问卷对参与者的社会人口统计学、生活方式参数和饮食习惯进行评估。采用标准程序测量人体测量参数、血压和生化指标。代谢综合征采用美国国立心肺血液研究所/美国心脏协会(HNLBI/AHA)的定义进行诊断,Chatzi等人对其进行了针对孕妇的修改。如果参与者至少符合以下三项标准,则记录为患有MS:孕前体重指数(BMI)>30 kg/m²;甘油三酯≥150 mg/dl;高密度脂蛋白胆固醇<50 mg/dl;收缩压≥130/舒张压≥85 mmHg;空腹血糖≥100 mg/dl。

结果

本研究纳入了604名孕妇。MS的患病率为17.88%(95%可信区间:15.03 - 21.14),其最常见的个体组成部分是高密度脂蛋白胆固醇水平低(66.23%(95%可信区间:62.36 - 69.88))和高甘油三酯血症(28%(95%可信区间:54.31 - 62.15))。与初产妇相比,经产妇患MS的风险更高(比值比:3.06,95%可信区间:1.24 - 7.12;p = 0.011)。即使在对年龄、产次、生活方式和饮食习惯进行调整后,孕前BMI似乎仍是孕期MS的最佳预测指标(比值比:46.46,95%可信区间:15.58 - 138.49;p < 0.0001)。

结论

雅温得健康区孕妇中MS的患病率为17.88%(95%可信区间:15.03 - 21.14),其主要决定因素是孕前肥胖。这项工作为预防策略的设计和改进提供了高质量的初步数据。

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