Prevalence, patterns and predictors of metabolic abnormalities in Nigerian hypertensives with hypertriglyceridemic waist phenotype: A cross sectional study

A systematic review and meta-analysis of the prevalence and risk factors of type 2 diabetes mellitus in Nigeria

BACKGROUND

Type 2 diabetes mellitus (T2DM) is a major global non-communicable disease, leading to increased morbidity and mortality. Its prevalence in Nigeria is driven by various risk factors. This review assesses the national and regional prevalence and risk factors of T2DM in Nigeria.

METHODS

Following PRISMA guidelines, electronic databases (PubMed, Scopus, Google Scholar, African Journals Online) and gray literature were searched for English-language studies. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. Data were extracted with Microsoft Excel and analyzed using Stata version 16 software. Random effect meta-regression analysis at 95% CI was used to assess pooled prevalence and risk factors. Heterogeneity was determined using the I2 statistic, and publication bias was evaluated with a funnel plot.

RESULTS

Sixty studies from different Nigerian geopolitical zones met eligibility criteria, with a total sample size of 124,876 participants and a mean age of 48 ± 9.8 years. The pooled prevalence of T2DM in Nigeria was 7.0% (95% CI: 5.0-9.0%). Moderate publication bias was observed. The South-south zone had the highest prevalence at 11.35% (95% CI: 4.52-20.72%), while the North-central zone had the lowest at 2.03% (95% CI: 1.09-3.40%). Significant risk factors included family history (9.73), high socioeconomic status (6.72), physical inactivity (5.92), urban living (4.79), BMI > 25/m2 (3.07), infrequent vegetable consumption (2.68), and abdominal obesity (1.81).

CONCLUSION

The prevalence of T2DM in Nigeria (7.0%) nearly doubled the 2019 International Diabetes Federation estimate (3.7%) and shows a 21.3% increase from the 2019 review. Efforts should focus on modifying identified risk factors to reduce prevalence and prevent complications.

The Hypertriglyceridemic Waist Phenotype is Associated with an Adverse Cardiometabolic Profile in this Cohort of Nigerians

Background

The hypertriglyceridemic waist (HTGW) phenotype was introduced as a means of identifying individuals at risk of developing metabolic syndrome as well as cardiovascular diseases and diabetes. However, studies surrounding the prevalence of the phenotype and its relationship with established markers of cardiometabolic risk, especially in the Nigerian population, remain sparse. This study aimed to determine the prevalence of the HTGW phenotype and explore its relationship with cardiovascular risk markers, namely Castelli Risk Indices I and II (CRI-I and CRI-II), Atherogenic Index of Plasma (AIP) and serum triglyceride-HDL cholesterol ratio (TG/HDL).

Methodology

In this retrospective cross-sectional study, the records of 206 patients presenting at a cardiac hospital from November 2022 to October 2023 were analysed. The HTGW phenotype was deemed present with a waist circumference of at least 94cm in men or 80cm in women and a serum triglyceride level of 150mg/dl or more in both sexes.

Results

At-risk waist circumference was more prevalent in women (92.7% vs 77.3%; p=0.002). The prevalence of the HTWG phenotype in the patient cohort was 29.6%, with more males than females (31.8% vs 27.1%) presenting with the phenotype (p=0.004). Patients with the phenotype also had higher systolic blood pressure, waist circumference, body mass index, triglycerides, AIP, and TG/HDL (all p<0.0005). The HTWG phenotype was also associated with a lower HDL and LDL cholesterol (p<0.0005) as well as a lower CRI-II (p=0.049).

Conclusion

The HTWG phenotype correlates with an increased cardiometabolic risk among Nigerians. This finding warrants the implementation of routine anthropometric and serum triglyceride measurements in screening programmes and hospitals for the early detection of individuals at risk of developing cardiovascular diseases.

Association of hypertriglyceridemic waist phenotype with metabolic syndrome traits and its diagnostic potential to predict metabolic syndrome in adults with excess body weight: A community-based cross-sectional study

BACKGROUND

The hypertriglyceridemic waist (HTGW) phenotype is a simple measure to identify individuals at increased risk of metabolic syndrome (MetS) traits. The present study aimed to describe the HTGW prevalence, and its associations with MetS traits, and also determine the diagnostic potential of the mirror indices of HTGW phenotype to predict MetS and its components in community-dwelling adults with overweight or obesity in Southern, Sri Lanka.

METHODS

In a cross-sectional study, 300 adults with excess body weight (body mass index >23 kg/m2) were enrolled and examined for the HTGW phenotype (fasting plasma triglyceride concentration ≥1.695 mmol/L and waist circumference >90 and >85 cm in males and females, respectively).

RESULTS

One in five adults with excess body weight had the HTGW phenotype. Phenotype-positive adults had significantly higher fasting plasma glucose (FPG) (p = 0.010), low-density lipoprotein cholesterol (HDL-C) (p < 0.001), total cholesterol (p < 0.001), atherogenic index (p < 0.001), coronary risk index (p = 0.001), triglyceride glucose index (p = 0.040), bioimpedance visceral fat (p = 0.041) and significantly lower HDL-C (p = 0.001) and cardioprotective index (p = 0.009) than those without the HTGW phenotype. Adults with excess body weight and the HTGW phenotype had an increased risk of FPG (odds ratio [OR] = 1.294; 95% confidence interval [CI] 1.051-1.594), atherogenic index (OR = 3.138; 95% CI = 1.559-6.317) and triglyceride glucose index (OR = 3.027; 95% CI = 1.111-8.249). The HTGW phenotype was strongly associated with MetS traits (OR = 16.584; 95% CI = 6.230-44.147). The cut-off values for the product of waist circumference × triglyceride, to identify the risk of having MetS and dyslipidemia among adults with excess body weight were 158.66 and 160.15 cm × mmol/L, respectively.

CONCLUSIONS

The readily available and inexpensive measures of the HTGW phenotype could serve as a clinically useful marker to identify MetS traits in adults with excess body weight.

Relationship Between Asymptomatic Hyperuricemia and the Hypertriglyceridemic-Waist Phenotype in Korean Adults: A Cross-Sectional Study

Purpose

Visceral fat accumulation can negatively affect uric acid metabolism in healthy adults. The hypertriglyceridemic-waist (HTGW) phenotype is a predictor of diabetes and cardiometabolic risk. This study aimed to investigate the association between the HTGW phenotype and asymptomatic hyperuricemia in Korean adults.

Patients and Methods

The study included 23,240 adults, aged 20-80 years who underwent comprehensive health examinations at a general hospital in Gyeonggi Province, Korea, from January 2020 to December 2022. The HTGW phenotype was defined as the simultaneous presence of elevated serum triglyceride (TG) levels and increased waist circumference (WC). The diagnostic capability of the HTGW phenotype for hyperuricemia and its association with the condition were assessed using the receiver operating characteristic (ROC) curve and logistic regression analysis.

Results

The prevalence of hyperuricemia in the HTGW phenotype was 3.44 times higher than that in the normal TG normal waist (NTNW) phenotype. Compared with those in the NTNW group, the hazard ratios for developing hyperuricemia in the HTGW group were 2.887 (2.566-3.249, P <0.001) for men and 7.341 (5.139-10.487, P <0.001) for women, and these values remained significant after adjusting for potential confounders. The stratified analysis revealed that the HTGW phenotype, coupled with diabetes, had the highest probability of developing asymptomatic hyperuricemia (2.55 times). ROC curve analysis revealed that the area under the curve values of the WC*TG index for hyperuricemia diagnosis were 0.702, 0.627, and 0.685 for all participants, men, and women, respectively.

Conclusion

Among Korean adults, the HTGW phenotype was closely related to hyperuricemia in both men and women and showed a particularly strong association in patients with diabetes. It may be used in combination with an indicator that can complement its accuracy for identifying individuals at high risk of hyperuricemia.