Prevalence and correlates of Metabolic Syndrome among adults in Freetown, Sierra Leone: A comparative analysis of NCEP ATP III, IDF and Harmonized ATP III criteria

Abstract

AbstractBackgroundMetabolic syndrome (MS) is a global health concern, especially for low and middle-income countries with limited resources and information. The study’s objective was to assess the prevalence of MS in Freetown, Sierra Leone, using the Adult Treatment Panel III (ATP III), International Diabetes Federation (IDF) and Harmonize ATP III. Additionally, we aimed to establish the concordance between these three different criteria used.MethodsThis community-based health screening survey was conducted from October 2019 to October 2022. A multistage stratified random design was used to select adults aged 20 years and above. Mean, interquartile range (IQR), and logistic regression were used for statistical analysis. The kappa coefficient statistics resolved the agreement between these defined criteria.ResultsThe prevalence for NCEP ATP III, Harmonize ATP III and IDF criteria was 11.8% (95% CI: 9.0 - 15.15), 14.3% (95% CI: 11.3 - 18.0), and 8.5% (95% CI: 6.2 - 11.2), respectively for the 2,394 selected adults. The kappa coefficient (κ) agreement between the MS is: Harmonized ATP III and IDF criteria = [(208 (60.8%); (κ =0.62)]; Harmonized ATP III and NCEP ATP III = [(201 (58.7%); (κ =0.71)]; while IDF and NCEP ATP III was [(132 (38.6%); (κ =0.52)]. In the multivariable regression analysis, waist circumference correlated with all three MS criteria: ATP III [AOR = 0.85; C.I 95%: (0.40-1.78), p = 0.032], Harmonized ATP III [AOR = 1.14; C.I 95%: (0.62-2.11), p = 0.024], IDF [AOR = 1.06; C.I 95% (0.52-2.16), p = 0.018]ConclusionWe reported a high prevalence of MS in Freetown, Sierra Leone and identified waist circumference as a major risk factor for MS. This underscores the crucial role of health education and effective management of MS in Sierra Leone.