THE PREVALENCE OF METABOLIC SYNDROME IN TYPE 2 DIABETICS AT THE LAGOS UNIVERSITY TEACHING HOSPITAL, LAGOS, NIGERIA

Abstract

Aims and objectives
This study is to determine the prevalence of metabolic syndrome (using the WHO
criteria which is the presence of diabetes plus two or more of the following:- obesity,
hypertension , dyslipidemia and microalbuminuria), obesity, hypertension and
microalbuminuria in type 2 diabetes and to correlate the presence of microalbuminuria
with glycaemic control in diabetic patients with and without metabolic syndrome.
Subjects and Methods
One hundred subjects with type 2 diabetes aged between 30-76 years were randomly
selected from patients attending the diabetic clinic at the Lagos University Teaching
Hospital, Lagos, Nigeria. One hundred age and sex matched healthy controls were
recruited from members of staff of the hospital. Clinical data was obtained by
interviewing the patients and controls and referring to case folders. Waist circumference,
waist/hip ratio (WHR), body mass index (BMI) and blood pressure measurements were
documented. Laboratory parameters analysed, included total cholesterol, high density and
low density lipoprotein cholesterol, triglyceride, microalbumin, plasminogen activator
inhibitor-1 and glycated haemoglobin. The Student's t test was used to test the differences
in the mean values of age, systolic blood pressure (SBP), diastolic blood pressure (DBP),
BMI, WHR, glycated haemoglobin (HbA1c), total cholesterol (TC), high density
lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C),
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triglyceride (TG), microalbumin, and plasminogen activator inhibitor-1 (PAI-1)between
the diabetics and controls and between diabetics with and without metabolic syndrome.
Chi square test was used to test the differences in proportion of diabetics and controls
with and without hypertension and microalbuminuria. Pearson’s correlation was used to
determine the relationship between HbA1c values and the values for microalbuminuria.
Statistical significance was set at P<0.05.
Results
Central obesity had the highest prevalence of 79% among the diabetic subgroup,
followed by hypertension (69%), low HDL (50%), general obesity (49%),
microalbuminuria (24%) and hypertriglyceridemia (10%). The risk factors that differed
significantly in both sexes were central obesity (p= 0.004) and general obesity
(p=0.01).The prevalence of metabolic syndrome was 86% in the diabetic subgroup.
Among the diabetic patients with metabolic syndrome, the commonest occurring and
least detected metabolic syndrome components were obesity (91.9%) and
microalbuminuria (24.4%) respectively. Eight percent of the subjects with metabolic
syndrome had all components of the syndrome. There was a moderate positive
relationship (r=0.52; p=0.01) between glycated HbA1c values and microalbuminuria in
diabetic patients with metabolic syndrome.
Conclusion
The prevalence of metabolic syndrome and its components (obesity, hypertension and
microalbuminuria) are very high in type 2 diabetics at the Lagos University Teaching

Hospital, Lagos, Nigeria and compares with findings from other parts of the country and
some parts of the world.