加纳博诺地区两家郊区医院糖尿病诊所就诊患者代谢综合征的决定因素。
Determinants of metabolic syndrome among patients attending diabetes clinics in two sub-urban hospitals: Bono Region, Ghana.
机构信息
Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana.
Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, College of Health Sciences, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana.
出版信息
BMC Cardiovasc Disord. 2022 Aug 10;22(1):366. doi: 10.1186/s12872-022-02805-4.
BACKGROUND
Over 70% of individuals with type 2 diabetes mellitus (T2DM) may have metabolic syndrome in sub-Saharan Africa. Evidence about the prevalence, clustering, and determinants of metabolic syndrome components is needed to guide the implementation of interventions to prevent cardiovascular diseases in low-income countries.
METHODS
A clinic-based cross-sectional study was conducted among 430 out-patients attending two-selected diabetes mellitus clinics in the Bono Region of Ghana. Data was collected in June 2016 among participants aged 30-79 years. The prevalence of metabolic syndrome was assessed using the harmonized definition. Patients were interviewed using semi-structured questionnaires and T2DM status was confirmed by reviewing medical records. The components of MS that were assessed included body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein (HDL)-cholesterol, and blood glucose. Multiple logistic regression models were constructed to evaluate the risk factors of MS.
RESULTS
The mean age of participants was 58.8 ± 11.49 years. The prevalence of MS was 68.6% (95% CI: 64.0-72.8), higher among women (76.3%, 95% CI: 70.6-81.2) than men (58.0%, 95% CI: 35.0-49.4) and in the 50-59-year age group (32.1%). The majority of participants [248 (57.7%)] had either two [124 (28.8%)] or four [124 (28.8%)] components of MS. Excluding fasting blood glucose (78.4%), the predominant components of MS identified in the study were reduced HDL cholesterol (70.2%), high waist circumference (60.9%), and elevated systolic blood pressure (49.8%). The study found that the odds of MS in women are 2.2-fold higher than in men (95% CI: 1.29-3.58, p = 0.003). Duration of T2DM (OR 5.2, 95% CI: 2.90-9.31, p < 0.001) and overweight status (OR 6.1, 95% CI: 3.70-10.07 p < 0.001) were also found to be significant determinants of MS.
CONCLUSIONS
Metabolic syndrome was common among patients attending routine diabetes mellitus clinics in sub-urban hospitals in the middle belt of Ghana. Significant factors associated with metabolic syndrome included being female, living with diabetes for more than five years, and being overweight. Nationwide advocacy for routine screening and prevention of the syndrome should be initiated to prevent cardiovascular disease and mortality in this vulnerable population.
背景
撒哈拉以南非洲地区超过 70%的 2 型糖尿病患者可能患有代谢综合征。为了指导在低收入国家实施预防心血管疾病的干预措施，需要有关于代谢综合征各组成部分的流行率、聚集和决定因素的证据。
方法
这是一项在加纳博诺地区的两家选定的糖尿病诊所进行的门诊患者的横断面研究。参与者年龄在 30-79 岁之间，于 2016 年 6 月进行数据收集。使用协调定义评估代谢综合征的患病率。使用半结构式问卷对患者进行访谈，并通过查阅病历确认 2 型糖尿病的状况。评估的 MS 组成部分包括体重指数、腰围、收缩压、舒张压、甘油三酯、高密度脂蛋白（HDL）胆固醇和血糖。构建了多变量逻辑回归模型来评估 MS 的危险因素。
结果
参与者的平均年龄为 58.8 ± 11.49 岁。代谢综合征的患病率为 68.6%（95%CI：64.0-72.8），女性（76.3%，95%CI：70.6-81.2）高于男性（58.0%，95%CI：35.0-49.4）和 50-59 岁年龄组（32.1%）。大多数参与者[248 名（57.7%）]有两种[124 名（28.8%）]或四种[124 名（28.8%）]MS 成分。除空腹血糖（78.4%）外，研究中确定的 MS 的主要成分是 HDL 胆固醇降低（70.2%）、腰围增大（60.9%）和收缩压升高（49.8%）。研究发现，女性患 MS 的几率是男性的 2.2 倍（95%CI：1.29-3.58，p=0.003）。2 型糖尿病的持续时间（OR 5.2，95%CI：2.90-9.31，p<0.001）和超重状态（OR 6.1，95%CI：3.70-10.07，p<0.001）也被发现是 MS 的显著决定因素。
结论
在加纳中腰带城市郊区医院的常规糖尿病诊所就诊的患者中，代谢综合征很常见。与代谢综合征相关的重要因素包括女性、患有糖尿病超过五年和超重。应在全国范围内倡导常规筛查和预防该综合征，以预防这一脆弱人群的心血管疾病和死亡率。
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