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      Metabolic syndrome for sub-Saharan Africans diabetes with peripheral arterial disease: a case-control study

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          Abstract

          Background

          Currently, there is no value for the definition of abdominal obesity by measuring waist circumference in the Sub-Saharan Africa. Several definitions of metabolic syndrome (MS) have disparities concerning use of waist circumference, including International Diabetes Federation (IDF), American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) and National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) definitions. The aim of the study was to determine what value of waist circumference should be used and whether to use it as obligatory criterion in the metabolic syndrome in case of peripheral arterial disease (PAD).

          Methods

          We conducted a case–control study in Cameroon. We included patients with diabetic foot and type 2 diabetes and excluded those with an Ankle Brachial Index (ABI) >?1.3. Cases were defined as patients with ABI?≤?0.9 and controls with ABI >?0.9. The significant p value was < 0.05 and odds ratio (OR) with 95% confidence interval was used to measured risk for have PAD with MS.

          Results

          We included 19 cases and 48 controls. The risk for having PAD with MS are for the IDF: OR = 4.7 (1.4-15.1), p = 0.008, for the AHA / NHLBI: OR = 5.8 (1.5-22.5), p = 0.007, for the NCEP-ATPIII: OR = 1.8 (0.6-5.6), p = 0.286.

          Conclusion

          Abdominal obesity should be defined according to the recommendations of the IDF and AHA / NHLBI and should not be an obligatory criterion in the definition of MS for research risk to have PAD on sub-Saharan Africa.

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          Most cited references13

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          WINPEPI updated: computer programs for epidemiologists, and their teaching potential

          Background The WINPEPI computer programs for epidemiologists are designed for use in practice and research in the health field and as learning or teaching aids. The programs are free, and can be downloaded from the Internet. Numerous additions have been made in recent years. Implementation There are now seven WINPEPI programs: DESCRIBE, for use in descriptive epidemiology; COMPARE2, for use in comparisons of two independent groups or samples; PAIRSetc, for use in comparisons of paired and other matched observations; LOGISTIC, for logistic regression analysis; POISSON, for Poisson regression analysis; WHATIS, a "ready reckoner" utility program; and ETCETERA, for miscellaneous other procedures. The programs now contain 122 modules, each of which provides a number, sometimes a large number, of statistical procedures. The programs are accompanied by a Finder that indicates which modules are appropriate for different purposes. The manuals explain the uses, limitations and applicability of the procedures, and furnish formulae and references. Conclusions WINPEPI is a handy resource for a wide variety of statistical routines used by epidemiologists. Because of its ready availability, portability, ease of use, and versatility, WINPEPI has a considerable potential as a learning and teaching aid, both with respect to practical procedures in the planning and analysis of epidemiological studies, and with respect to important epidemiological concepts. It can also be used as an aid in the teaching of general basic statistics.
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            Cardiovascular complications of diabetes mellitus in sub-Saharan Africa.

            Cardiovascular disease, the major cause of mortality and morbidity in modern societies, is set to overtake infectious diseases in the developing world as the most common cause of death. The increasing prevalence of major and emerging cardiovascular risk factors accounts for the growing burden of cardiovascular disease in the world. Diabetes in all its forms is one of the main cardiovascular risk factors. Two of 3 diabetic patients will die as a result of cardiovascular complications, and approximately 30% of patients treated in cardiovascular intensive care units have diabetes. This review on the cardiovascular complications of diabetes in sub-Saharan Africa is a bibliographical MEDLINE search of published data over the past 2 decades. Diabetes-related cardiovascular disease complications are considered to be rare in Africa but are on the rise and are regularly associated with classic cardiovascular risk factors. Coronary heart disease may affect 5% to 8% of type 2 diabetic patients and cardiomyopathy, up to 50% of all patients. Close to 15% of patients with stroke have diabetes, and up to 5% of diabetic patients present with cerebrovascular accidents at diagnosis. Peripheral vascular disease prevalence varies across sites from 4% to 28%. It is obvious that diabetes mellitus and related cardiovascular complications are gaining more importance in sub-Saharan Africa. The relative contribution of putative risk factors is not well defined, and further research is therefore needed.
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              High prevalence of diabetes mellitus and metabolic syndrome in a South African coloured population: baseline data of a study in Bellville, Cape Town.

              The coloured population has the second-highest prevalence of diabetes in South Africa. However, the data were based on a study conducted almost 20 years ago in a peri-urban coloured population of the Western Cape. We aimed to determine the prevalence of diabetes mellitus and metabolic syndrome in an urban coloured population in South Africa. In a cross-sectional survey, 642 participants aged ≥31 years were drawn from an urban community of Bellville South, Cape Town, from mid-January 2008 to March 2009. Type 2 diabetes was assessed according to the WHO criteria, and metabolic syndrome was based on the International Diabetes Federation (IDF), ATP III and 2009 Joint Interim Statement (JIS) definition. The crude prevalence of 28.2% (age-adjusted 26.3%, 95% confidence interval (CI) 22.0 - 30.3) for type 2 diabetes was: 4.4% (age-adjusted 3.2%, 95% CI 1.6 - 4.9) for impaired fasting glycaemia, and 15.3% (age-adjusted 15.0%, 95% CI 11.4 - 18.6) for impaired glucose tolerance. Undiagnosed type 2 diabetes was present in 18.1% (age-adjusted 16.8%, 95% CI 13.3 - 20.4). The crude prevalence of metabolic syndrome was higher with the JIS definition (62.0%) than the IDF (60.6%), and the National Cholesterol Education Program (NCEP) ATP III (55.4%). There was good overall agreement between the MetS criteria, k=0.89 (95% CI 0.85 - 0.92). The prevalence of diabetes has increased hugely in the coloured community, and the high prevalence of undiagnosed diabetes portends that cardiovascular diseases might grow to epidemic proportions in the near future in South Africa.
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                Author and article information

                Journal
                BMC Res Notes
                BMC Res Notes
                BMC Research Notes
                BioMed Central
                1756-0500
                2014
                24 February 2014
                : 7
                : 104
                Affiliations
                [1 ]Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, P.O. Box 1364, Yaoundé, Cameroon
                [2 ]Goulfey District Hospital, Goulfey, Cameroon
                [3 ]Orthopedic Surgery and Traumatology Department, Yaoundé Central Hospital, P.O. Box 5555, Yaoundé, Cameroon
                [4 ]National Centre of Obesity, Yaoundé Central Hospital, P.O. Box 5555, Yaoundé, Cameroon
                Article
                1756-0500-7-104
                10.1186/1756-0500-7-104
                3938317
                24564882
                8db9386e-86c4-4d09-b55c-d62dbf9ff143
                Copyright © 2014 Bigna et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.

                History
                : 13 August 2013
                : 19 February 2014
                Categories
                Research Article

                Medicine
                africa,metabolic syndrome,endocrine disorders,peripheral arterial disease,low-income country,diabetic foot

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