The prevalence of metabolic syndrome and its predominant components among pre-and postmenopausal Ghanaian women

BMC Research Notes

Lawrence Owusu¹  Faustina Obu Mensah²  James Osei-Yeboah³  Michael Adu-Frimpong³  Fareed Kow Nanse Arthur² 

[1] Department of Medical Biochemistry and Molecular Biology, Dalian Medical University, 9 Western Section, Lvshun South Street Lvshunkou District 116044, Dalian City, PR China;Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;Department of Medical Laboratory Technology, College of Health, Kintampo, Ghana

关键词: Cardiovascular disease;    Obesity;    Premenopausal;    Adiposity;    Postmenopausal;    MetS;   

Others  :  1140910
DOI  :  10.1186/1756-0500-6-446

 received in 2013-05-29, accepted in 2013-11-05,  发布年份 2013

【 摘 要 】

Background

Metabolic Syndrome (MetS) is a clump of risk factors for development of type 2 diabetes mellitus and cardiovascular diseases. Menopause and age are thought to predispose women to the development of metabolic syndrome. This study aimed to estimate the prevalence of MetS and identify its predominant components among pre-and postmenopausal women in the Kumasi Metropolis, Ghana.

Two hundred and fifty (250) Ghanaian women were randomly selected for the study. They were evaluated for the prevalence of metabolic syndrome using the World Health Organization (WHO), National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), International Diabetes Federation (IDF) and Harmonization (H_MS) criteria.

Results

Out of the total subjects, 143 (57.2%) were premenopausal and 107 (42.8%) menopausal. The study population was between the ages of 20–78 years. The overall percentage prevalence of MetS were 14.4%, 25.6%, 29.2% and 30.4% according to the WHO, NCEP-ATP III, IDF and H_MS criteria, respectively. The prevalence was found to increase with age, irrespective of criterion used. Generally, MetS was significantly higher among postmenopausal women (p < 0.05 by all criteria) compared to their premenopausal cohort, but with marked inter-criteria variations. Abdominal obesity, blood pressure, fasting blood glucose, triglyceride, very low density lipoprotein cholesterol, and triglyceride-high density lipoprotein cholesterol ratio were significantly (p < 0.05) different among the two groups of women.

Central obesity, higher blood pressure and raised fasting blood glucose were the predominant components that contributed to the syndrome in Ghanaian women.

Conclusion

The higher prevalence of the metabolic syndrome in postmenopausal women is an indication that they are at risk of developing cardiovascular disease and type 2 diabetes. Therefore women in that group should be monitored for the two conditions and also be advised to adopt healthy lifestyles to minimize the incidence of these conditions.

【 授权许可】

   
2013 Kow Nanse Arthur et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Kengme A, Albert G, Amoah B, Mbanya J: Cardiovascular Complications of Diabetes Mellitus in Sub-Saharan Africa. Circulation 2005, 112:3592-3601.
• [2]Liu C-S, Hsu H-S, Li C-I, Jan C-I, Li T-C, Lin W-Y, Lin T, Chen Y-C, Lee C-C, Lin C-C: Central Obesity and Atherogenic Dyslipidemia in Metabolic Syndrome are Associated with Increased Risk for Colorectal Adenoma in a Chinese Population. BMC Gastroenterol 2011, 10:51.
• [3]Alberti K, Zimmet P, Shaw J: Metabolic Syndrome: a New World-Wide Definition: a Consensus Statement from the International Diabetes Federation. Diabet Med 2006, 23(5):469-480.
• [4]Rossi R, Nuzzo A, Origliani G, Modena M: Metabolic Syndrome affects Cardiovascular Risk Profile and Response to Treatment in Hypertensive Postmenopausal Women. Hypertension 2008, 52:865-872.
• [5]Petri NE, Padoani N, Nahas-Neto J, Orsatti F, Tardivo A, Dias R: Metabolic Syndrome and its Associated Risk Factors in Brazilian Postmenopausal Women. Climacteric 2009, 12(5):431-438.
• [6]Lobo R: Metabolic Syndrome after Menopause and the Role of Hormones. Maturitas 2008, 60(1):10-18.
• [7]Kim H, Park J, Ryu S, Kim J: The Effect of Menopause on Metabolic Syndrome among Korean Women: the Korean National Health and Nutrition Examination Survey, 2001. Diabetes Care 2007, 30(3):701-706.
• [8]Heidari R, Sadeghi M, Talaei M, Rabiei K, Mohammedfard N, Sarrafzadegan N: Metabolic Syndrome in Menopausal Transition: Isfahan Healthy Heart Program, a Population Based Study. Diabetol Metab Syndr 2010, 2:59. BioMed Central Full Text
• [9]Indhavivadhana S, Rattanachaiyanont M, Wongvananurak T, Kanboon M, Techatraisak K, Leerasiri P: Predictors for Metabolic Syndrome in Perimenopausal and Postmenopausal Thai Women. Climacteric 2010. In Press
• [10]Neto J, Figueredo E, Barbosa J, Barbosa F, Costa G, Nina V, Nina R: Metabolic Syndrome and Menopause: Cross-sectional Study in Gynaecology Clinic. Sociodade Braziera de Cardiologia 2010, 4:20-27.
• [11]Tandon V, Mahajan A, Sharma S, Sharma A: Prevalence of Cardiovascular Risk Factors in Postmenopausal Women: A Rural Study. J Mid life Health 2010, 1:26-29.
• [12]Park Y, Zhu S, Palaniappan L, Heshka S, Carnethon M, Heymsfield S: The Metabolic Syndrome Prevalence and Associated Risk Factor Finding in the US Population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med 2003, 163:427-536.
• [13]Sowers J: Update on Cardio Metabolic Syndrome. Clin Cornerstone 2001, 4(2):17-23.
• [14]Helge J: Prolonged Adaptation to Fat Rich Diet and Training; Effects on Body Fat Stores and Insulin Resistance in Man. Intern J Obes 2002, 26:1118-1124.
• [15]Balkau B, Vierron E, Vernay M, Born C, Arondel D, Petrella A, Ducimetiere P: The Impact of 3-year Changes in Lifestyle Habits on Metabolic Syndrome Parameters: The D.E.S.I.R Study. Eur J Cardiovasc Prev Rehabil 2006, 13:334-340.
• [16]GDHS: Ghana Statistical Service (GSS), Ghana Health Service (GHS), and ICF Macro. Ghana Demo-graphic and Health Survey: Accra, Ghana: GSS. GHS, ICF Macro 2008, 2009:2009.
• [17]Arthur FKN, Adu-Frimpong M, Osei-Yeboah J, Mensah FO, Owusu L: Prediction of Metabolic Syndrome among Postmenopausal Ghanaian Women using Obesity and Atherogenic Markers. Lipids Health Dis 2012, 11:101-114. BioMed Central Full Text
• [18]Oh J, Hong Y, Sung Y-A, Barrett-Connor E: Prevalence and Factor Analysis of Metabolic Syndrome in an Urban Korean Population. Diabetes care 2004, 27(8):2027-2032.
• [19]Fleiss JL, Tytun A, Ury HK: A Simple Approximation for Calculating Sample Sizes for Comparing Independent Proportions. Biometrics 1980, 36:343-346.
• [20]van Belle G: Statistical Rule of Thumb. 2nd edition. New York: Wiley Interscience; 2008.
• [21]WHO: World Health Organization (WHO), Expert Committee on Physical Status: the use and Interpretation of Anthropometry: Report of a WHO Expert Committee. Geneva: World Health Organization; 1995.
• [22]Kirkendall W, Burton A, Epstein F, Freis E: Recommendations for Human Blood Pressure Determination by Sphygmomanometers. Circulation 1967, 36(6):980-988.
• [23]Friedewald W, Levy R, Fredriskson D: Estimation of the Concentration of Low-density Lipoprotein Cholesterol in Plasma without use of the Preparative Ultra-Centrifuge. Clin Chem 1972, 18:499-502.
• [24]Gyakobo M, Amoah A, Martey-Marbell D-A, Snow R: Prevalence of the Metabolic Syndrome in a Rural Population in Ghana. BMC Endocr Disord 2012, 12:25-34. BioMed Central Full Text
• [25]Grundy S, Cleeman IJ: Diagnosis and Management of the Metabolic Syndrome. Circulation 2005, 112(17):2735-2752.
• [26]Cameron A, Shaw J, Zimmet P: The Metabolic Syndrome: Prevalence in Worldwide Population. Endocrinol Metab Clin North Am 2004, 33(2):351-375.
• [27]Hyun Y, Kim O, Jang Y, Ha J, Chae J, Kim J: Evaluation Metabolic Syndrome Risk in Korean Premenopausal Women: Not Waist Circumference but Visceral Fat. Circ J 2008, 72(8):1308-1315.
• [28]Deibert P, Konig D, Vitolins M, Landmann U, Frey I, Zahradnik H: Effect of Weight Loss Intervention on Anthropometric Measures and Metabolic Risk Factors in Premenopausal Women. Nutr J 2007, 6:31. BioMed Central Full Text
• [29]Ruan X, Jin J, Hua L, Wang J, Liu S: The Prevalence of Metabolic Syndrome in Chinese Postmenopausal Women and the Optimum Body Composition Indices to Predict it. Menopause: J North Am Menopause Soc 2010, 17(3):566-570.
• [30]Choi K, Kim S, Kim Y, Choi D, Baik S, Lee J: Prevalence and Cardiovascular Disease Risk of the Metabolic Syndrome Using National Cholesterol Education Program and International Diabetes Federation Definitions in the Korean Population. Metabolism 2007, 56(4):552-555.
• [31]Saira A, Bashir M: Prevalence of Metabolic Syndrome in Pre and Postmenopausal Diabetics. Biomedica 2008, 24:26-30.
• [32]Piche M, Weisnagel S, Corneau L, Nadeau A, Lemieux S: The WHO and NCEP-ATP III Definitions of Metabolic Syndrome in Postmenopausal Women: Are They so Different? Metab Syndr Relat Disord 2006, 4(1):17-27.
• [33]Kim H, Park J, Ryu S, Kim J: The Effect of Menopause on the Metabolic Syndrome among Korean Women: The Korean National Health and Nutrition Examination Survey, 2001. Diabet Care 2007, 30:701-706.
• [34]Hidalgo L, Chedraui P, Morocho N, Alvarado M, Chavez D, Huc A: The Metabolic Syndrome among Postmenopausal Women in Ecuador. Gynecol Endocrinol 2006, 22(8):447-454.
• [35]Ainy E, Mirmiran P, Asl S, Azizi F: Prevalence of Metabolic Syndrome during Menopausal Transition Tehranian Women: Tehran Lipid and Glucose Study (TLGS). Maturitas 2007, 58(2):150-155.
• [36]Pandey S, Srinivas M, Agasha S, Joshi J, Galvanka P, Prakasam C, Vaidya R: Menopause and Metabolic Syndrome: A Study of 498 Urban Women from Western India Medical Research Centre of Kasturba Health Society. ICMR Adv Centre Reverse Pharmacol 2010, 2(1):63-69.
• [37]Kelliny C, William J, Riesen W, Paccaud F, Bovet P: Metabolic Syndrome According to Different Definitions in a Rapidly Developing Country of the African Region. Cardiovasc Diabetol 2008, 7:27. BioMed Central Full Text
• [38]Samaras K, Kelly P, Chiano MN: Genetic and Environmental Influence on Total and Central Abdominal Fat: The Effect of Physical Activity in Female Twins. Ann Intern Med 1999, 130:873-882.
• [39]Paul S, Smith L: The Metabolic Syndrome in Women: A Growing Problem for Cardiac Risk. J Cardiovasc Nurs 2005, 20:427-432.
• [40]Oliveira E, Souza M, Lima M: Prevalence of Metabolic Syndrome in Rural Area in Semiarid Region of Bahia State. Arq Bras Endocrinol Metab 2006, 50(3):456-465.
• [41]Romanski SA, Nelson RM, Jensen MD: Meal Fatty Acid Uptake in Adipose Tissue: Gender Effects in Nonobese Humans. Am J Physiol 2000, E279:E455-E462.
• [42]Poehlman E: Menopause, Energy Expenditure and Body Composition. Acta Obstet Gynecol Scand 2002, 81(7):603-611.
• [43]Zhang H, Reymer P, Liu M: Patients with ApoE3 Deficiency (E2/2, E3/2, and E4/2) who Manifest with Hyperlipidemia have Increased Frequency of an Asn 291 Ser Mutation in the Human LPL Gene. Arterioscler Thromb Vasc Biol 1995, 15:1695-1703.
• [44]Johnson L, Weinstock R: The Metabolic Syndrome: Concepts and Controversy. Mayo Clin Proc 2006, 81:1615-1620.
• [45]Koh KK, Quon MJ, Rosenson RS, Chung WJ, Han SH: Vascular and Metabolic Effects of Treatment of Combined Hyperlipidemia: Focus on Statins and Fibrates. Int J Cardiol 2008, 124:149-159.
• [46]Pohjantahti-Maaroos H, Palomaki A, Kankkunen P, Laitinen R, Husgafvel S, Okasanen K: Circulating Oxidised Low-density Lipoproteins and Arterial Elasticity: Comparison Between Men with Metabolic Syndrome and Physically Active Counterparts. Cardiovasc Diabetology 2010, 9:41. BioMed Central Full Text
• [47]Bruce C, Sharp D, Tall A: Relationship Between HDL and Coronary Heart Disease to a Common Amino Acid Polymorphism in the Cholesterol Ester Transfer Protein in Men and without Hypertriglyceridemia. J Lipid Res 1998, 39:1071-1078.
• [48]Despres J, Moorjani S, Tremblay A, Ferland M, Lupien P, Nadeau A, Bouchard C: Relation of High Plasma Triglyceride Levels Associated with Obesity and Regional Adipose Tissue Distribution to Plasma Lipoprotein-lipid Composition in Premenopausal Women. Clin Invest Med 1989, 12(6):374-380.
• [49]Sandhofer A, Kaser S, Ritsch A, Laimer M, Engl J, Paulweber B, Patsch J, Ebenbichler C: Cholesteryl Ester Transfer Protein in Metabolic Syndrome. Obesity 2006, 14:812-818.
• [50]Rashid S, Uffelman K, Lewis G: The Mechanism of HDL Lowering in Hypertriglyceridemic, Insulin-resistant States. J Diabetes Complications 2002, 16(1):24-28.
• [51]Jaber L, Brown M, Hammad A, Zhu Q, Herman W: The Prevalence of the Metabolic Syndrome among Arab Americans. Diabetes Care 2004, 27:234-238.
• [52]Rexrode K, Carey V, Hennekens C, Walter E, Colditz G, Stampfer M, Willett W, Manson J: Abdominal Adiposity and Coronary Heart Disease in Women. JAMA 1998, 280:1843-1848.
• [53]Schubert C, Rogers N, Remsberg K, Sun S, Chumelea W, Demerath E, Czerwinski S, Towne B, Siervogel R: Lipids, Lipoproteins, Lifestyle, Adiposity and Fat-free Mass during Middle Age: The Fels Longitudinal Study. Int J Obes 2006, 30:251-260.
• [54]Cho G, Lee J, Park H: Postmenopausal Status According to Years since Menopause as an Independent Risk Factor for the Metabolic Syndrome. Menopause: J North Am Menopause Soc 2008, 15:524-529.
• [55]Shi H, Cleqq D: Sex Differences in the Regulation of Body Weight. Physiol Behav 2009, 97:199-204.
• [56]Leon A, Sanchez O: Response of Blood Lipids to Exercise Training Alone or Combined with Dietary Intervention. Med Sports Exerc 2001, 33:s502-s515. discussions528-509
• [57]Fahlman M, Broardley D, Lambert C, Flynn M: Effects of Endurance Training and Resistance Training on Plasma Lipoprotein Profiles in Elderly Women. J Gerontol A Biol Sci Med-Sci 2002, 57:B54-B60.
• [58]Kraus W, Houmard J, Dusecha B, Knetzger K, Wharton M, McCartney J, Bales C, Henes S, Samsa G, Otvos J, et al.: Effects of the Amount and Intensity of Exercise on Plasma Lipoproteins. N Engl J med 2002, 347:1483-1492.
• [59]Owiredu W, Amidu NE, Gockah-Adapoe E, Ephraim R: The Prevalence of Metabolic Syndrome among Active Sportsmen/Sportswomen and Sedentary Workers in the Kumasi Metropolis. J Sci Technol 2011, 31(1):23-36.