Prevalence and Risk Factors of Metabolic Syndrome Among Type 2 Diabetics Attending AL-Thawra Hospital, Sana'a City-Yemen

Abstract

Background of the study: Metabolic syndrome (MetS) is a combination of insulin resistance, hyperinsulinemia, hyperglycemia, dyslipidemia, high blood pressure and central obesity. MetS is found along with Diabetes Mellitus (DM) predisposes patients to cardiovascular disease and stroke. Socioeconomic factors such as sedentary lifestyle and eating habits are important risk factors for developing this syndrome.

Objective of the study: This study to find out the prevalence and risk factors of metabolic syndrome among type 2 diabetic attending the Diabetes Center at Al Thawra Modern General Hospital (TMGH), Sana'a, Yemen.

Study method: Descriptive, cross-sectional study was conducted among T2DM patients who attended the Diabetes Center at TMGH, Sana'a from July to September 2020. A sample size of 219 T2DM patients aged between 19 and 80 years was selected in this study using Non-probating sampling (convenience). After consent to participate, the blood sample was taken by venous blood collection method using 5ml syringes by trained nurses, to check the FBS and lipids and was examined by Roche Organ. While waiting for the results, researcher the tanken the measurements (blood pursuer, anthropometric) though observation. demographic data, family medical history and personal habits during the face-to-face interview of the patient using a prepared questionnaire as well as. The following components of the MetS have been documented: triglycerides, high-density lipoprotein, fasting glucose analysis, as well as measurement of systolic and diastolic blood pressure. It was also checked whether the patients have taken any medication for hypertension or dyslipidemia. The ongoing study adopted the criteria of the National Cholesterol Education Program(NCEP)-Adult Treatment Panel(ATP) III for the diagnosis of MetS. Data were encoded, entered and analyzed using SPSS version 25.0 (version 25.0). Measurements were made using frequencies and percentages of categorical variables, means and standard deviation of quantitative variables using chi-square, Fisher's test according to the required statistical treatment. P-Value < 0.05 is statistically significant.

RESULTS: Among the 210 T2DM patients analyzed, 108 (51.4%) were male and 102 (48.6%) were female. The age mean ranged between 50.61 ± 11.82 years. According to the criteria of the NCEP - ATP III, 177 (84.3%), patients were diagnosed with MetS, of which 84 (47.5%) of the patients were male, and 93 (52.5%) were female. The prevalence of MetS was higher between the age of 36 -50 years at a rate of (41.8%) and among urban dwellers with a percentage of (65.5%) and among the illiterate at a rate of (40.1%),and the prevalence of the MetS was among housewives (48.0%) and among income enough (50.3%). There was a significant association between the MetS and patients' age, gender, educational level and occupation (p < 0.035, p < 0.008, p < 0.022, 0.001 p <) respectively. However, there was no statistically significant association between MetS and place of residence, income, family medical history, personal habits and diabetes complications. Patients with T2DM taking antihypertensive drugs had a six-fold increased odds of developing MetS (OR = 6.698, P < 0.00), and those taking statins (statins) had a three-fold increased risk of developing MetS (OR = 3.543, P = 0.01). All diabetic patients with systolic hypertension and diastolic hypertension were at thirteen and twenty-three times the risk of developing MetS than the non-diabetic patients, respectively (OR=13, OR=23). The T2DM patients who had a high waist circumference were at risk of developing MetS almost five times more than others (OR = 4.941; p = 0.000). There was no association between body mass index and MetS (p = 0.560). T2DM with low HDL values were seven times as likely to have MetS (OR = 7.019). MetS had association with both triglycerides and fasting glucose The odds ratio was eight times for high triglycerides and nine times for high fasting glucose (OR=8.347;p=0.000, OR=9.262;p=0.001), but it was not significant with the glycosylated hemoglobin test.

Conclusion and Recommendations: The current study showed that the prevalence of MetS was found to be high among T2DM patients. This data is important for planning of future comprehensive surveillance and monitoring of metabolic diseases, and formulating preventive and therapeutic strategies like lifestyle modification, behavioral therapy, diet education and nutritional therapy and upgrading the overall health of the people. As well as, it is essential for formulating strategies for early diagnosis through effective screening for obesity, hypertension, altered lipid profile and glucose intolerance.