CARDIOVASCULAR JOURNAL OF AFRICA • Vol 21, No 3, May/June 2010
Cardiovascular Topics
148
AFRICA
The association between anthropometric parameters,
the metabolic syndrome and microalbuminuria in black
Africans: the SABPA study
S HOEBEL, JH DE RIDDER, L MALAN
Summary
We aimed to determine which surface anthropometric and
metabolic syndrome (MS) markers could be associated with
the development of microalbuminuria (MA), and assessed
200 urban Africans (25–60 years) stratified into low (
≤
0.90 and
≤
0.85) and high (
>
0.90 and
>
0.85) waist-to-
hip ratio (WHR) groups from the North-West province.
Anthropometric and fasting MS markers, such as systolic
and diastolic blood pressure (BP), and glucose, triglyceride
(TG) and high-density lipoprotein (HDL) levels, as well as
MA markers were measured.
Males revealed higher lifestyle risk factors (body mass
index, smoking, alcohol consumption, low physical activ-
ity), anthropometric and MS markers compared to the
females. The same overall trend was seen for high-WHR
males but not for high-WHR females compared to their
low-WHR counterparts. Both high-WHR groups revealed
increased glucose values (males, 6.34 mmol/l; females, 6.13
mmol/l). Multiple linear regression analysis, independent of
confounders, showed positive associations between diastol-
ic blood pressure (DBP) (high WHR and all males), TG,
waist circumference (WC) and development of MA in all
males. In high-WHR females, positive associations existed
only between WC and the development of MA, while neck
circumference (NC) was associated with MA development
in all females. To conclude, vascular BP, TG and WC were
associated with risk of renal impairment in males, while in
females, NC and WC circumferences were associated with
this risk.
Keywords:
anthropometric, metabolic syndrome, microalbu-
minuria, black Africans
Submitted 27/11/09, accepted 10/3/10
Cardiovasc J Afr
2010;
21
: 148–152
DOI: CVJ-21.012
According to Rheeder,
1
33 million people worldwide will have
diabetes by the year 2025. Not much information is available
concerning the extent of this tendency in the black African popu-
lation (hereafter referred to as Africans). In terms of well being,
urbanised Africans are a vulnerable group.
2,3
The reason is that
they have higher central obesity, blood pressure (BP) and stress
levels,
4
as well as inadequate levels of physical activity and poor
dietary habits.
5
This places them at an increased risk for develop-
ing chronic diseases such as type 2 diabetes and cardiovascular
diseases,
2,3,6-8
especially when they become urbanised.
9
The increased incidence of type 2 diabetes contributes to
the increased frequency of developing cardiovascular disease.
6,7
Other than macrovascular complications, this increased preva-
lence of cardiovascular diseases in diabetic persons could be
due to an increase in the metabolic syndrome (MS).
10,11
Using
the criteria of the World Health Organisation (WHO) the MS is
represented by a cluster of risk factors which can also be present
in type 2 diabetics. These factors include hypertension, high
levels of blood glucose, triglycerides (TG), high-density lipopro-
teins (HDL), microalbuminuria and central obesity.
10,11
In Caucasians, central obesity is associated with an increased
waist-to-hip ratio (WHR).
11
According to the WHO, the WHR
can be seen as a risk factor to health when it exceeds 0.90 for
the male and 0.85 for the female population.
11
This measure is
used as a simple method to determine body fat distribution.
12
The MS risk can also be determined from waist circumference
(WC) measurement and when it exceeds 102 cm for the males
and 88 cm for the females, it becomes a risk factor.
12
No clear
cut-off points for Africans exist and it has been suggested by the
International Diabetes Federation (IDF)
10
that European anthro-
pometric data be used as a reference when working with the
African population. However, not only does data differ between
ethnic groups, but there is also a difference in the type of disease
prevalence between genders. African-American females have a
greater tendency to present with diabetes than their male coun-
terparts
13-15
and the mortality rate is found to be higher in female
diabetics than males.
13
The information obtained from this study could be useful for
screening purposes in Africans. Screening will help people to
acquire the necessary understanding of the underlying factors
in order to reduce or even prevent the increasing prevalence of
the MS as well as other chronic diseases of lifestyle. Screening
is of further use to ensure a better quality of life, and it is also
cost saving in terms of disease prevention. The parameters iden-
tified during this study could be used to determine a quick and
School of Biokinetics, Recreation and Sport Science,
and School for Physiology, Nutrition and Consumer
Sciences North-West University, Potchefstroom Campus,
Potchefstroom, South Africa
S HOEBEL, BSc (Hons)
JH DE RIDDER, PhD
L MALAN, PhD, RN,
