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Prediabetes and metabolic syndrome in Nigerian adults : prevalence and risk screening

Oguoma, Victor Maduabuchi (2016). Prediabetes and metabolic syndrome in Nigerian adults : prevalence and risk screening. PhD Thesis, Charles Darwin University.

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Author Oguoma, Victor Maduabuchi
Title Prediabetes and metabolic syndrome in Nigerian adults : prevalence and risk screening
Institution Charles Darwin University
Publication Date 2016
Thesis Type PhD
Supervisor Skinner, Timothy C.
Nwose, Ezekiel U.
Richards, Ross S.
1117 - Public Health and Health Services
Abstract In Nigeria, the prevalence and incidence of prediabetes and metabolic syndrome are constantly on the rise. There are inadequate efforts underway to address the trend, such as by screening the ‘at risk’ population. Part of this inadequacy arises from the use of sub-optimal risk screening approaches which have not been validated for use at the local population. Thus, it has become imperative to project the national prevalence of metabolic syndrome as well as to recommend approaches to risk screening for prediabetes and metabolic syndrome in Nigeria.

A systematic review of the literature was carried out to summarise the public health and clinical research carried out over the last 12 years in Nigeria. The WHO STEPS approach for non-communicable disease risk factor surveillance was then applied in rural and urban populations through the application of a two-stage cluster sampling technique. The WHO, Third Adult Treatment Panel (ATP-III) and International Diabetes Federation definitions were the main criteria used for defining metabolic syndrome. The average prevalence of metabolic syndrome was found to be 28%, and the prevalence of prediabetes was found to range from 4.9% to 5.7%. Access to risk screening was found to be higher among participants with higher educational qualifications, while those who were yet to seek medical attention cited affordability as the reason for not seeking healthcare. Half of the study population were physically inactive, while there was poor agreement between the use of metabolic syndrome and cardiovascular disease risk scores (based on the Framingham/ATP-III model) for screening the ‘at risk’ individuals. Moreover, the optimal waist circumferences for classifying metabolic syndrome and diabetes found in this study differed from the waist circumference thresholds currently in use.

Further research to assess the prevalence and risk factors that cause metabolic syndrome among the rural populations where lifestyles are not yet Westernised is highly anticipated. The results of the present study indicate that there is an urgent need for access to diagnosis of modifiable risk factors at all levels of Nigerian society since income levels and educational qualifications do not mitigate the prevalence of these risk factors. The complementary use of cardiovascular disease risk scores and metabolic syndrome is important in order to enhance risk identification. Finally, the sub-optimal use of the obesity cut-off points defined by the WHO, ATP-III and IDF in the Nigerian population must be addressed.

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