Prevalence and Correlates of Glucose Homeostasis Abnormalities in the Far-North Region Cameroon

Background: Evidence indicates a growing burden of glucose homeostasis abnormalities (namely type 2 diabetes mellitus (T2DM) and prediabetes) in Cameroun. The aim of this study was to assess the prevalence and correlates of glucose homeostasis abnormalities (GHA) in the Far-North region of Cameroon, where these variables have not been explored so far. Methods: We included in this population-based cross-sectional survey 461 participants living urban area (Maroua) and 428 dwellers living in rural area (Tokombere) aged at least 18 years, using a multistage-cluster sampling frame. In all participants, we recorded sociodemographic, medical history, clinical data and fasting blood (capillary) glucose (FBG). Diabetes was considered for FBG ≥ 126 mg/dL or being on glucose-lowering medications, and impaired fasting glycemia (IFG) for FBG 100 - 125 mg/dL. Results: The overall age-standardized prevalence of GHA, IFG and diabetes was 33.6%, 21.7% and 11.9%, respectively. Those data were similar between urban and rural areas. Determinants of GHA were age, overweight/obesity, abdominal obesity and hypertension. IFG was only related to abdominal obesity, while diabetes was related to age, family history of diabetes, overweight/obesity, abdominal obesity and hypertension. Conclusion: Glucose homeostasis abnormalities are alarmingly high in Far North Cameroon. Efforts are needed to promote healthier lifestyles and initiate diabetes-screening campaigns in Cameroon.

Prehypertension, Hypertension and Associated Cardiovascular Risk Factors among Adult Congolese Urban Dwellers: Results of the Vitaraa Study

Objective: To assess the prevalence of prehypertension and hypertension, their determinants and associated cardiovascular risk factors in Congolese urban dwellers. Methods: From July 2007 to March 2008, we collected information on lifestyle habits, medical history and anthropometric data in 1292 household members of Adoula Quarter, Kinshasa, aged 20 years or more, 731 women (56.6%). We obtained measurements of BP, blood glucose, serum lipids and qualitative proteinuria. We defined blood pressure categories according to JNC7 classification and used logistic regression analyses to assess their independent determinants. We obtained age adjustment of continuous and categorical variables using GLM and Genmod procedures, respectively. Results: Prehypertension was observed in 30.3% of subjects, 34.9% of men and 26.7% of women (P = 0.0045). The prevalence of hypertension amounted to 30.9% with no difference between genders. Participants with prehypertension had average age, BMI and waist circumference intermediate between those with normal BP and hypertensive subjects. Their glucose and lipids levels were similar to those of normotensives. The prevalence of prehypertension amounted to 33% at age 20 - 29 years and decreased to 16.7% at ≥60 years whereas the prevalence of hypertension increased from 11.2% to 71.4%. The rates of diabetes mellitus were similar accross blood pressure catogo- ries whilst prevalences of overweight/obesity, abdominal adiposity, dyslipidemia and metabolic syndrome significatively increased (P = 0.05 or less). Among participants with prehypertension, 73% had two or more additional cardiovascular risk factors. In the logistic model the probability of prehypertension was higher in men (OR: 1.429;95% CI: 1.099 - 1.857) and participants with overweight/obesity (OR: 1.666;1.146 - 2.422), lower in participants aged ≥ 55 years (0.427;0.267 - 0.683) and those with high fruit intake (0.691;0.488 - 0.977). The probability of hypertension was higher in participants aged ≥ 55 years (OR: 6.988;4.561 - 10.706), overweight/obesity (2.263;1.704 - 3.004), those with high vegetables consumption (1.152;1.003 - 1.324) and faster pulse rate (1.013;1.002 - 1.025). Conclusion: Our results suggest that fruit consumption and control of over-weight are important issues for prevention of cardiovascular disease in sub-Saharan Africa where high blood pressure is the main driver of the current epidemic.