A comparative study of the prevalence of the metabolic syndrome and its components in type 2 diabetic patients in two Caribbean islands using the new International Diabetes Federation definition

• Published in: Archives of physiology and biochemistry Vol. 113; no. 4-5; pp. 202 - 210
• Main Authors: Ezenwaka, C. E., Nwagbara, E., Seales, D., Okali, F., Hussaini, S., Raja, B., Wheeler, V., Sell, H., Avci, H., Eckel, J.
• Format: Journal Article
• Language: English
• Published: Basingstoke Informa UK Ltd 01.10.2007; Taylor & Francis
• Subjects: Age Distribution; Biological and medical sciences; Blood Pressure; cardiovascular disease; Caribbean; central obesity; Demography; diabetes mellitus; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - ethnology; Diabetes Mellitus, Type 2 - physiopathology; Female; Fundamental and applied biological sciences. Psychology; Geography; Glycated Hemoglobin A - metabolism; Humans; International Agencies; Life Style; Lipid Metabolism; Male; metabolic syndrome; Metabolic Syndrome - complications; Metabolic Syndrome - epidemiology; Metabolic Syndrome - ethnology; Metabolic Syndrome - physiopathology; Middle Aged; Obesity - complications; Prevalence; Risk Factors; Sex Characteristics; Trinidad and Tobago - epidemiology; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Endocrinopathy; Type 2 diabetes; Human; Obesity; Nutrition disorder; central obesity; Metabolic diseases; Cardiovascular disease; diabetes mellitus; Metabolic syndrome; prevalence; Vertebrata; Mammalia; Caribbean; Nutritional status; Comparative study
• ISSN: 1381-3455; 1744-4160
• DOI: 10.1080/13813450701475201

Abstract Background and aim: Tobago and Trinidad are two Caribbean islands with distinct genetic background and lifestyles; while Tobago is serene and a tourist centre, Trinidad is characterized by a hustling and bustling lifestyle. The study was aimed at determining and comparing the prevalence of the metabolic syndrome (MetS) and its critical components in type 2 diabetic patients using the new International Diabetes Federation (IDF) definition. Methods: Four hundred and thirteen (166 Tobago, 247 Trinidad) type 2 diabetic patients visiting 10 lifestyle disease clinics were studied. Blood pressure, anthropometric parameters (height, weight, body mass index and waist circumference) and overnight fasting blood samples were taken. Plasma glucose and serum triglycerides, total cholesterol, LDL- and HDL-cholesterol, insulin, and adiponectin were determined. Insulin resistance (IR) was determined using the HOMA method. Results: The patients in Tobago were significantly older than patients in Trinidad (p < 0.001) but the duration of diabetes (9.4 ± 0.5 vs. 11.1 ± 0.7 yr), medications, generalized (31.7 vs. 38.8%) and central (78.5 vs. 83.7%) obesity were similar (p > 0.05). In comparison with patients in Tobago, diabetic patients in Trinidad, irrespective of gender, had significantly higher prevalence of IDF critical components such as raised BP, raised triglycerides and reduced HDL-cholesterol (all, p < 0.001). Thus, while more patients in Trinidad were diagnosed with MetS based on three or four components, more patients in Tobago were diagnosed based on two components (p < 0.001). Conclusions: There were high prevalence rates of the components of the MetS in both the islands of Tobago and Trinidad. Quantitatively, the aggregation of the components is higher in patients in Trinidad, which constitute greater risk for adverse cardiovascular outcome. Controlling central obesity should be the target in preventing MetS in the two islands.