Metabolic syndrome in newly diagnosed type 2 diabetes mellitus using NCEP.ATP III, the Nnewi experience

Background and Objectives: Type 2 diabetes is becoming epidemic and several studies have shown that diabetes is associated with increased co.morbidities and impaired functional health in the general adult population. Type 2 diabetes is one of the co.morbidities associated with metabolic syndrome that carries with it increased risk of cardiovasculardisease and death. The purpose of this study is therefore to determine the prevalence of metabolic syndrome in newly diagnosed type 2 diabetes mellitus subjects seen at Nnewi South East Nigeria.Design and Setting: This is a cross.sectional study in newly diagnosed diabetics attending a private hospital.Hope Specialist Hospital, Nnewi.Materials and Methods: One hundred and eighteen (118) newly diagnosed diabetic patients were recruited into the study consisting of those who on routine screening were found to have elevated blood glucose or were symptomatic of the disease and presented for treatment.Statistical Analysis: Statistical analysis was carried out using SPSS version 13. Studentfs t.test was used for continuous variables, and a ƒÔ2 test was used for categorical variables. In the analyses a P..value of <0.05 was considered statistically significant.Results: Of the 118 subjects, 25 were removed from the study because their samples were lost as a result of prolonged power outage leaving 93 subjects consisting of 47 males and 46 females. The mean (SD) and the range of age was 55.27 (12.55) years, 24.84 years; SBP 153.52 (29.83) mmHg,100.230 mmHg; DBP 94.23 (15.42) mmHg, 60.140 mmHg;TC 5.17 (1.4) mmol/L, 2.0.11.12 mmol/L; LDL.C 2.06 (1.55) mmol/L, 0.1.9.4 mmol/L; HDL.C 1.28 (0.48) mmol/L, 0.15.2.8 mmol/L; TG 1.75 (0.85) mmol/L, 0.50.5.0 mmol/L; BMI 30.30 (6.23) kg/m2, 17.84.49.12 kg/m2; and WC of the general population mean (SD) 96.86 (7.16) cm, range 84.112 cm; for men 101.40 (3.88) cm, range 85.108 cm and for women 92.22 (6.77) cm, 84.112 cm. Metabolic syndrome was found in 62 (66.7%) subjects of which 26 (41.9%) were males and 36 (58.1%) were females (P < 0.019). The prevalence of different components of metabolic syndrome was as follows:hypertension was found in 75 (80.6%): 37 males and 38 females (P = 0.635), dyslipidemia in 31 (60.8%): 19 males and12 females (P = 0.572). Obesity was found in 23 (45.1%): 8 males and 15 females (P < 0.014). Of the study subjects 33 had hypertension prior to the diagnosis of diabetes mellitus (DM). Seventeen males had hypertriglyceridemia against 11 females (P = 0.357). Equal number of males and females (11 each) had low HDL..C (P = 0.603).Conclusion: The study shows that metabolic syndrome is highly prevalent in newly diagnosed type 2 diabetes patients and the most common risk factor is hypertension

Lipid and Some Other Cardiovascular Risk Factors Assessment in a Rural Community in Eastern Nigeria

Background: Continuous re‑evaluation of modifiable cardiovascular risk factors (cardiovascular diseases [CVDs]) in developing nations is imperative as it lays foundation for early preventive/intervention measures at grass root level to improve/prevent CVD morbidity and mortality in those nations where health indices still score below the standard.Aim: The aim was to assess CVD risk factors as a continuous re‑evaluation of these may underscore the need for early intervention measures at grass root level.Subjects and Methods: A total of 257 apparently healthy inhabitants aged 18–85 years were recruited in a rural community in South Eastern Nigeria by convenient sampling. Blood pressure, waist circumference and blood lipid analysis were done procedurally and data analyzed using SPSS 16.0 statistical software.Results: The males were older (59.41 [5.22]) than the females (53.31 [16.90]). 69.2% (133/192) were low level farmers, retirees and dependents. Total cholesterol (TC), low density lipoprotein (LDL), and risk predictive index were higher in females while triglyceride (TG), high density lipoprotein and very LDL (VLDL) were higher in males. The middle aged and elderly respectively had higher TG and VLDL compared to the young. Aside hypertriglyceridemia, all lipid abnormalities were higher in females than males both singly (high TC: 28.9% [35/121] vs. 16.9% [12/71]; high LDL cholesterol: 52.0% [63/121] vs. 31.0% [22/71]) and in combination hypercholesterolemia with hypertriglyceridemia (42.9% [52/121] vs. 36.6% [26/71]). “Multiple risk factors” also occurred more in females with seeming further increase in older age.Conclusion: The chances of a female having CVD after menopause seemed to outweigh that of the male. CVD preventive measures should be focused at the primary/community level as a means to curtailing the increasing morbidity and eventual mortality from CVDs. Keywords: Blood pressure, Homogenous community, Lipids, Waist circumferenc

Blood Pressure and Obesity Index Assessment in a Typical Urban Slum in Enugu, Nigeria

Background: Rapid transition from rural to urban lifestyle in Africa has been associated with increasing cardiovascular disease burden and thus, the need for continuous reevaluation of cardiovascular risk factors in African slums which have been shown to harbor 40 to 80% of urban residents cannot be over emphasized.Objectives: To evaluate hypertension and obesity in a typical urban slum in South East, Nigeria.Design: Cross-sectional community based study.Setting: A typical urban slum in Enugu State, Eastern Nigeria.Subjects: One hundred and ninety one volunteers from the slum.Results: The mean age of the entire participants in this study was 44.1 ± 16.2 years while their mean BMI was 25.1 ± 5.2 Kg/m2. Their mean systolic BP was 128.8 mmHg ± 22.2 and 79.0mmHg ± 12.9 for mean diastolic BP. Both systolic and diastolic blood pressure (BP) increased as age group increased peaking at the age group 55- 74 years and then dropping after 75 years. Mean BMI peaked at 35- 54 years and then started dropping as age increased. In the entire community, 29.3% of the participants had hypertension (males: 42.1 %, females: 23.9%), 25.1% had isolated systolic HBP (ISH) while 22.0% had isolated diastolic HBP (IDH). In the general population, the general prevalence of HBP and ISH increased as age group increased. IDH increased as age increased peaking at 55- 74 year age group (34.1%) and then dropped thereafter (≥75; ISH=10.0%). Among the females, HBP prevalence increased across board as age increased but among the males, it increased with age and peaked at 55-74 year age group (61.1%) and then dropped (≥75; HBP= 57.1%). The prevalence of obesity in the community was 13.1% (males; 5.3%, females; 16.4%). None of those ≥75 years had obesity. Obesity prevalence was highest in those 35-54 years old (17.6%) and least in those 15- 34 years old (9.1%). Generally and within all age groups, females had higher obesity prevalence than the males. For the males, Obesity was highest in those 55-74 years (11.1%) while for the females, it was highest in those 35-54 years (23.0%). Prevalence of HBP increased with BMI getting to more than double fold in those found to be obese. 26% of the participants (20.8% of males and 31.3% of females) who were found to have hypertension had prior knowledge of it.Conclusion: Hypertension and obesity are on the increase in Nigeria and degree of ignorance about these major cardiovascular risk factors has remained very high

Compliance with clinic appointments by hypertensive patients after discharge in a tertiary hospital, South East Nigeria

Objective: Compliance with clinic appointment is one of the several ways to assess patients' adherence to treatment with varying rates of compliance with scheduled visits being reported. This study was carried out with the aim of assessing the level of compliance with clinic appointments of our hypertensive patients after discharge from the ward.Method: This is a retrospective study. The case notes of consecutive patients admitted into the medical wards over a 2-year period, from 1st January 1996 to 31st December 1997, were reviewed. Those admitted with hypertension, or with its associated complications like heart failure, cerebrovascular accident (stroke), were studied for their compliance with clinic appointments after discharge, from 1st January 1998 to 31st December 1999. Compliance was divided into 4 categories: a) those who did not attend outpatient clinic at all after discharge; b) those who attended less than six times before dropping out; c) those who attended more than six times but dropping out before the end of 1999; and d)those who kept regular appointments up to the end of 1999. Analyses was done using SPSS. Means and the respective standard deviations and proportions were used to describe the distribution of the data. The chi-square test was used to determine the statistical significance of the difference between the proportions, and the student t-test was used to compare means. A p-value of <0.05 was considered statistically significant.Results: A total of 211 patients were studied, 105(49.8%) were males and 106(50.2%) females. The mean age (SD) of the population was 58.46±12.23 years, with a range of 24–88 years. There was no statistically significant difference in the ages of the female and male subjects (p= 0.309. Ninety-eight (46.4%) of the 211 patients did not attend clinic at all after discharge, 65(30.8%) attended a few times, 16(7.6%) had moderate attendance and 32 (12.2%) had full clinic attendance for the duration of the study.Conclusion: The findings showed a poor compliance to follow-up appointments in clinics by hypertensive patients admitted into Nnamdi Azikiwe University Teaching Hospital, Nnewi. Key-words:, Clinic, Appointment, Attendance Compliance, Hypertension

Evaluation of risk factors and markers for cardiovascular disease in diabetic patients: The Nnewi experience.

Objectives: The study was designed to investigate the lipid profile, C- reactive protein and urinary level of micro-albumin as part of routine riskassessment in diabetic patients.Subjects and Methods: Plasma levels of total cholesterol, low density liproprotein cholesterol (LDL – C), high density lipoprotein cholesterol(HDL –C), triglyceride (TG), C- reactive protein and urinary levels of micro-albumin were evaluation in 40 diabetic patients and 40 controlsubjects. The patients were aged 45-50 years and were age-matched with the control. Data were analyzed with student test and Pearsoncorrelation coefficient.Results: The results indicate that fasting plasma glucose (FPG) was significantly raised in diabetic patients (8.9+4.0mmol/L) compared withcontrol subjects (4.6+ 0.5mmol/L,

Evaluation of liver function tests of HIV positive patients on Antiretroviral Therapy in Nnewi,Nigeria.

Liver enzymes-alanine and aspartate aminotransferases and alkaline phosphatase (AST, ALT and ALP), bilirubin and serum proteins were determined using standard laboratory methods and these parameters were used to evaluate the liver function of human immunodeficiency virus (HIV)- positive patients receiving antiretroviral therapy (ART). The study was conducted on two hundred (200) HIV-positive patients (100 HIV-positive patients that were not on ART, 43 HIV-positive patients on ART for three months and 57 HIV-positive patients on ART for six months). One hundred (100) apparently healthy HIV-negative individuals served as control subjects. All subjects were between the ages of 18 to 55 years, mean age 33.6±9.0. There was statistically significant increase in the activities of the liver enzymes (AST, ALT, ALP), of HIV positive patients not on antiretroviral therapy (ART). Similar increases were also observed in HIV positive patients on ART for three months and six months respectively compared with HIV negative control subjects (

Hypertension prevalence and awareness amongst a group of women attending August meeting

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Evaluation of blood pressure and indices of obesity in a typical rural community in eastern Nigeria

Aim: With increasing urbanization of lifestyle, cardiovascular morbidity and mortality have been on the increase in Africans. Studies on cardiovascular risk factors in rural communities in South East Nigeria are scarce. This study focused on hypertension and obesity in adult Nigerians dwelling in a rural setting in Eastern Nigeria. Materials and Methods: A total of 218 participants from the rural community were recruited into the study. A questionnaire was used to assess prior knowledge of their weight and blood pressure status as well as drug history for those found to have hypertension. Each participant's blood pressure was measured and any value ≥140/90 mmHg was regarded as high blood pressure (HBP). Their heights and weights were measured and their body mass indices (BMI) calculated using the standard formula of BMI = Weight in Kg/Height in m 2 ; BMI ≥30 Kg/m 2 was referred to as global obesity. Their waist circumferences (WC) were also measured and any value ≥102 cm for males and ≥88 cm for females was regarded as abdominal obesity. Results: The general prevalence of HBP in the rural community was 44.5%. The prevalence of HBP increased as age increased and awareness about HBP was low (15.2%). Females were more aware than the males. The prevalence of HBP was higher in males (49.3%) compared with their female counterparts (42.3%), whereas the females had a higher prevalence of all forms of obesity (abdominal: 36.2%, global: 14.8%) compared with the males (abdominal: 14.5%, global: 10.1%). Higher BMI was associated with higher systolic and diastolic BP values. Hypertensive participants had higher BMI and WC than those who had normal BP. Conclusion: The prevalence of both hypertension and obesity seems to be increasing in rural communities in Nigeria and thus, the available prevalence documented in previous studies for rural communities may no longer represent the current trend. Awareness of the participants about these major cardiovascular risk factors is still very low. Higher BMI was associated with higher values of both systolic and diastolic BP.DOI: 10.4103/1596-3519.8207