A Comparative Prevalence Of Metabolic Syndrome Among Type 2 Diabetes Mellitus Patients In Hawassa University Comprehensive Specialized Hospital Using Four Different Diagnostic Criteria

Abstract

Background

Recognition of MetS in type two diabetic patients is important in starting the appropriate preventive and therapeutic measures. The commonly used definitions of MetS have similarities and discrepancies. Different definitions defined metabolic syndrome differently. IDF, WHO, NCEP-ATP III, and the harmonized definitions were used frequently to determine the prevalence of metabolic syndrome.

Objectives

This study was aimed to investigate the prevalence of MetS and its associated factors among patients with type 2 Diabetes Mellitus using four definitions and to identify the concordance and the difference of these four definitions.

Methods

A cross-sectional study was conducted from February 28 to May 30/2017 at Hawassa university comprehensive specialized hospital. The study involved 314 study participants selected by simple random sampling technique. Logistic regression was used to determine associated factors of metabolic syndrome, and kappa statistics was used to determine the concordance between different definitions of metabolic syndrome. In any cases, a p-value of <0.05 was considered to be statistically significant.

Result

The prevalence of metabolic syndrome according to IDF, WHO, harmonized, and NCEP-ATP III diagnostic criteria was 59.9%, 31.2%, 65.6%, and 70.1%, respectively. Our study found the maximum agreement between IDF and NCEP criteria (K=0.54, P<0.001) and IDF and Harmonized(K=0.65, P<0.001). Uric acid level was associated factor of metabolic syndrome by all the four definitions, and total cholesterol was associated factors by the three definitions.

Conclusion

The prevalence of metabolic syndrome varies based on the definition used and the highest prevalence of MetS was observed with NCEP-ATP III and the different types of criteria do not always diagnose the same group of individuals.

Keywords:

• type 2 DM
• metabolic syndrome
• Hawassa
• Ethiopia

Acknowledgments

We would like to thank the College of Health Sciences, Jimma University for supporting this project. We also thank the study participants, data collectors and those who had a contribution to this study.

Abbreviations

BMI, Body Mass Index; CVD, cardiovascular diseases; DBP, diastolic blood pressure; FBS, fasting blood Sugar; HDL-c, high-density lipoprotein cholesterol; HUCSH, Hawassa University comprehensive specialized Hospital; IDF, International Diabetic Federation; LDL-c, low-density lipoprotein cholesterol; NCEP ATP, National cholesterol education program Adult treatment panel; RPM, revolution per minute; SBP, systolic blood pressure; SPSS, statistical package for social sciences; T2DM, Type 2 Diabetes mellitus; WHO, World Health Organization.

Ethical Consideration

This study was conducted according to the Declaration of Helsinki. Ethical clearance was obtained from the ethical review committee of the Institute of Health Sciences, Jimma University. This ethical clearance was taken to HUCSH clinical director office and a permission letter to conduct the study was taken from the clinical director office to the HUCSH diabetic clinic and to the medical laboratory department to conduct the study. Then, the aim, purpose, benefits, and method of the study were clearly explained to the participants. Written informed consent was obtained from each participant and the names of patients were not registered in the questionnaire and their unique MRN numbers were locked for confidentiality. The study participants were informed that they can withdraw from the study at any time and has no negative impact on their diagnosis and treatment in the hospital. Finally, each study participants had provided signed consent before any data collected.

Availability Of Data And Material

The data that support the findings of this study are at Hawassa Comprehensive Specialized Hospital but not publicly available. However, the data are available from the authors upon reasonable request and with the permission of Hawassa Comprehensive Specialized Hospital ethics committee.

Author Contributions

All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work. ATA reviewed and reanalyzed the dataset and reviewed the manuscript and references to get the final version.

Funding

The study was supported by the College of Health Sciences of Jimma University.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

The study was supported by the College of Health Sciences of Jimma University.