SA JOURNAL OF DIABETES & VASCULAR DISEASE RESEARCH ARTICLE VOLUME 19 NUMBER 1 • July 2022 7 on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) criterion17 to determine the presence of the MetS. The prevalence they reported (Garrido et al. at 34.0% and Omech et al. at 27.1%) were almost similar to that of the current study (30.4%).13 These results confirm a prevalence of the MetS of approximately 31% among Batswana adults, indicating an emerging population-wide health problem. Similar to our findings, Erasmus et al.19 and Peer et al.20 also reported a higher prevalence (60.6%) in urban South African mixed-ancestry populations, and a high age-adjusted prevalence of 31.7% among blacks in the same population. The prevalence in SSA varies between 0 and 50% or even higher,21 placing Botswana among the most afflicted countries in the region, at 32.7%. The prevalence of the MetS was found to be higher among women, at 44.5%, compared to men at 20%, corresponding to most studies that investigated the prevalence of the MetS in SSA,6,19,20,22-24 as well as African-Americans.25 Peer et al.19 attributed this gender difference in SSA and African-Americans to cultural values and positive social attitudes towards obesity. Traditionally, being overweight among these cultures is generally associated with good health and attractiveness in women,20 as is the custom also among the Batswana.12,26 Furthermore, due to the HIV/AIDS epidemic in Botswana, adiposity is associated with being HIV/AIDS negative and most women would naturally prefer to be overweight. The high prevalence of the MetS and obesity among women is of great concern and urgently needs culturally sensitive interventions. The oldest age group (55–65 years) was found to be more at risk for the MetS (~70% of women and 41.2% among men). Several studies reported an increased MetS prevalence with ageing in SSA.27-31 The MetS seemed to escalate in women between 55 and 65 years, which might be related to the physiological changes occurring with pre-menopause and menopause.32,33 The high prevalence of the MetS among women in the current study is of great concern. It is therefore necessary to initiate screening for CVDs earlier or at the onset of menopause and screening should also be available to younger at-risk women in order to prevent the early onset of NCDs. The two MetS risk factors accompanying central obesity that were found to be the most prevalent among all women were low HDL-C and high TG levels (Table 1). Among the women with the MetS, the most prevalent risk factors were still found to be low HDL-C and high TG levels (Fig. 1). Visceral fat contributes to dyslipidaemia, which was observed among the women in this study.4 The most prevalent risk factor accompanying central obesity in the men was elevated BP, followed by low HDL-C levels (Table1). Among men with the MetS, the risk factors accompanying central obesity were elevated TG, followed by elevated BP (Fig. 1). The present results reveal high TG levels as an emerging high MetS risk factor predominant in both men and women with the MetS. Here, our results are similar to Erasmus et al.19 who reported a prevalence of the MetS of 75%, low HDL-C levels in women, and 51.4% of men residing in the predominantly black townships of Cape Town, South Africa had elevated BP. Characterising the most prevalent risk factors in the MetS can help guide interventional programmes geared towards lowering the risk of acquiring the MetS, as the risk factors can be isolated and individually treated. Overall, the three most common risk factors for the MetS were found to be central obesity, elevated BP and dyslipidaemia (low HDL-C and high TG levels), suggesting a high risk for CVDs in the population investigated. The results are not surprising since increased obesity has been reported to increase circulating free fatty acid concentrations, thus increasing plasma TG levels.4 To successfully prevent or treat the MetS, lifestyle modification and pharmacological interventions should be employed. Pharmacologically, medications for the treatment of all the MetS Fig 1. Proportion with risk components among metabolic syndrome participants. CUSTOMER CARE LINE +27 21 707 7000 www.mydynami cs.co.za PEARINDA PLUS 8. Each tablet contains 8 mg perindopril tert - butylamine and 2,5 mg indapamide. S3 A49/7.1.3/0013. For full prescribing information, refer to the professional information approved by SAHPRA, 20 April 2021. PAA924/05/2022. THE ENDURANCE ACE- i PERINDOPRIL TERT-BUTYLAMINE/ INDAPAMIDE 8/2,5 mg ATHLETE: AJ Calitz – CHAMPION TRAIL RUNNER BIOEQUIVALENT TO THE ORIGINATOR PERINDOPRIL ARGININE/INDAPAMIDE 10/2,5 mg Percentage (%) 90 80 70 60 50 40 30 20 10 0 High triglycerides High fasting glucose Elevated BP Low HDL-C Male Female 80.3 66.9 47.9 49.7 77.6 61.7 76.3 74.7
RkJQdWJsaXNoZXIy NDIzNzc=