Metabolic syndrome for sub-Saharan Africans diabetes with peripheral arterial disease: a case-control study.

Background: Currently, there is no value for the definition of abdominal obesity by measuring waist circumference in the Sub-Saharan Africa. Several definitions of metabolic syndrome (MS) have disparities concerning use of waist circumference, including International Diabetes Federation (IDF), American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) and National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) definitions. The aim of the study was to determine what value of waist circumference should be used and whether to use it as obligatory criterion in the metabolic syndrome in case of peripheral arterial disease (PAD).

Methods: We conducted a case-control study in Cameroon. We included patients with diabetic foot and type 2 diabetes and excluded those with an Ankle Brachial Index (ABI) > 1.3. Cases were defined as patients with ABI ≤ 0.9 and controls with ABI > 0.9. The significant p value was < 0.05 and odds ratio (OR) with 95% confidence interval was used to measured risk for have PAD with MS.

Results: We included 19 cases and 48 controls. The risk for having PAD with MS are for the IDF: OR = 4.7 (1.4-15.1), p = 0.008, for the AHA/NHLBI: OR = 5.8 (1.5-22.5), p = 0.007, for the NCEP-ATPIII: OR = 1.8 (0.6-5.6), p = 0.286.

Conclusion: Abdominal obesity should be defined according to the recommendations of the IDF and AHA/NHLBI and should not be an obligatory criterion in the definition of MS for research risk to have PAD on sub-Saharan Africa.