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Original research
Prevalence and sex-specific patterns of metabolic syndrome in rural Uganda
  1. Limor Ben-Yacov1,
  2. Pearl Ainembabazi1,
  3. Aliza Hannah Stark1,
  4. Samuel Kizito2 and
  5. Silver Bahendeka3
  1. 1 School of Nutritional Sciences and the International School of Agricultural Sciences, The Hebrew University of Jerusalem, Rehovot, Israel
  2. 2 Clinical Epidemiology Unit, Makerere University College of Health Sciences, Kampala, Uganda
  3. 3 Medical School, Uganda Martyrs University, Kampala, Uganda
  1. Correspondence to Dr Limor Ben-Yacov, School of Nutritional Sciences, Hebrew University of Jerusalem, Rehovot 76100, Israel; limor.ben-yacov{at}mail.huji.ac.il

Abstract

Background and aims In sub-Saharan Africa, infectious diseases are still the leading causes of mortality; however, this may soon be surpassed by non-communicable illnesses, namely hypertension, diabetes and cardiovascular disease. This study determined the prevalence and patterns of metabolic syndrome and cardio-risk factors in men and women in rural Uganda.

Methods A household-based, cross-sectional survey was carried out following the WHO STEP-wise approach to surveillance. It included demographic and lifestyle questionnaires, anthropometric measurements and biochemical analyses. Of the 200 randomly recruited participants, 183 successfully completed two steps of the study and 161 provided blood samples.

Results Data were collected from 183 adults, aged 18–69 years; 62% were female. Based on the National Cholesterol Education Program-Adult Treatment Panel-III criteria, the prevalence of metabolic syndrome was 19.1% (95% CI 14.0 to 22.5). Elevated fasting plasma glucose was observed in 14.2% (95% CI 9.1 to 19.3) of participants, hypertriglyceridaemia in 16.9% (95% CI 12.1 to 23.1); hypertension in 36.1% (95% CI 29.0 to 43.0) and 52.5% (95% CI 45.2 to 59.6) had low HDL (high-density lipoprotein) cholesterol. Abdominal obesity was found in 24.6% (95% CI 18.8 to 31.4) of participants. Sex disparities were significant for several risk factors. Females had significantly higher prevalence of abdominal obesity (38.6% vs 1.5% in males, p=0.001) and twice the rates of low HDL (65.8% vs 30.4%, p=0.001). Men tended to have higher but not significant rates of hypertension (42.0% vs 32.5%) and smoked significantly more than women (49.3% vs 21.1%, p<0.001). Alcohol consumption was also higher in men (55.1% vs 18.4%, p<0.001) and quantities consumed were approximately three times greater than in females (p<0.001).

Conclusion Metabolic syndrome exists at worrying rates in the rural Ugandan population. Sex disparities are evident in risk factor prevalence, reflecting physiological variables and deeply entrenched cultural and lifestyle norms.

  • metabolic syndrome
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjnph-2019-000050

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    Footnotes

    • Contributors LB-Y was involved in all stages of the research. She was responsible for the overall planning and design of the study, data interpretation and drafting the initial manuscript. PA was an MSc student on this project and participated in study design, was responsible for data and sample collection and processing and final review of the manuscript. AHS served as a consultant throughout the research and was involved in manuscript writing. SK performed statistical analysis and final review of the manuscript. SB was involved in the study design, was responsible for laboratory analyses and supervising the field work from start to finish. He also critically reviewed the final version of the manuscript.

    • Funding This study was funded by Pears Foundation (UK), DAS Handling Ltd (Uganda).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available on reasonable request.