CARDIOVASCULAR JOURNAL OF AFRICA • Volume 33, No 5, September/October 2022 238 AFRICA prevalence of obesity (p = 0.02) and men with MA had a lower prevalence of overweight than those without MA (p = 0.02). Table 5 presents predictors of MA in the total population with confounders controlled for in analysis. Participants with hypertension were more likely to have MA compared to their counterparts without hypertension [AOR 3.365 (95% CI: 1.111– 10.188) (p = 0.03)]. Participants with a high insulin level (last quartile) were more likely to have MA than those in the last quartile of insulin [AOR 6.068 (95% CI: 1.568–3.474) (p = 0.01)]. Table 6 presents predictors of MA in men having controlled for confounders. Men with a high hs-CRP were less likely to have MA [AOR 0.204 (95% CI: 0.069–0.602) (p = 0.00)]. Men with a high HOMA were more likely to have MA than those with a normal HOMA [AOR 2.982 (95% CI: 1.413–6.294) (p = 0.00)]. Men with high hs-CRP and TG levels were more likely to have MA compared to those with normal hs-CRP and TG levels [AOR 9.434 (95% CI: 1.753–50.778) (p = 0.01)]. Table 7 presents the predictors of MA in women. Women with a high glucose level were less likely to have MA [AOR 0.597 (95% CI: 0.356–0.976) (p = 0.04)]. Women with a high insulin level (last quartiles) were more likely to have MA than those in the first quartile [AOR 2.905 (95% CI: 1.436–5.877) (p = 0.00)]. Discussion This study aimed to assess the prevalence of MA and further determine the association of MA with inflammatory markers and serum lipid levels in a rural black population in the Dikgale HDSS, South Africa. The study showed that women had significantly higher hs-CRP levels (p = 0.01) and a higher prevalence of high hs-CRP (p ≤ 0.001) compared to men. Furthermore, women had a higher prevalence of high TG levels compared to men (p = 0.02), while men had a significantly higher prevalence of low HDL-C levels compared to women (p ≤ 0.001). Table 4. Anthropometry and blood pressure by MA status in men and women Variables Male p-value Female p-value NA (n = 137) MA (n = 88) NA (n = 250) MA (n = 127) BMI (kg/m2) 23.30 ± 4.85 24.03 ± 6.79 0.38 26.77 ± 6.91 27.66 ± 8.25 0.27 WC (cm) 80.18 ± 12.79 79.81 ± 11.09 0.83 87.90 ± 15.14 88.74 ± 13.55 0.60 SBP (mmHg) 132.98 ± 18.38134.89 ± 29.64 0.59 125.28 ± 21.51134.94 ± 30.60 0.00 DBP (mmHg) 81.80 ± 13.74 81.06 ± 15.61 0.72 80.98 ± 13.21 83.93 ± 14.78 0.05 Overweight, n (%) 34 (27.6) 15 (19.7) 0.02 68 (28.9) 32 (26.4) 0.54 Obese, n (%) 11 (8.9) 17 (22.4) 70 (29.8) 43 (35.5) High WC, n (%) 21 (15.7) 11 (12.6) 0.53 175 (71.4) 89 (70.6) 0.87 High SBP, n (%) 45 (32.6) 28 (32.2) 0.95 57 (22.9) 50 (39.1) 0.00 High DBP, n (%) 26 (19.3) 25 (29.4) 0.08 57 (23.3) 46 (35.6) 0.01 % hypertension, n (%) 66 (47.8) 38 (43.7) 0.54 99 (39.8) 73 (57.0) 0.00 BMI, body mass index; WC, waist circumference; SBP, systolic blood pressure; DBP, diastolic blood pressure. Table 5. Multivariate regression analysis of MA with serum lipids and inflammatory markers in the total population Variable Odds ratio (95% CI) p-value Age, years ≤ 39 1 (Ref) 40–59 0.819 (0.288–2.324) 0.71 ≥ 60 2.197 (0.792–6.099) 0.13 Hypertension Normal 1 (Ref) Hypertension 3.365 (1.111–10.188) 0.03 Glucose Normal 1 (Ref) High 0.466 (0.188–1.156) 0.0 SBP Normal 1 (Ref) High 0.282 (0.070–1.136) 0.08 HDL-C Normal 1 (Ref) Low 0.463 (0.156–1.371) 0.16 LDL-C Normal 1 (Ref) High 0.461 (0.203–1.046) 0.06 Insulin First quartile 1 (Ref) Last quartile 6.068 (1.568–23.474) 0.01 Gender, HDL-C Male normal 1 (Ref) Female low 2.448 (0.615–9.735) 0.20 SBP, systolic blood pressure; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol. Table 6. Multivariate regression analysis of MA with serum lipids and inflammatory markers in men after adjustment Variable Odds ratio (95% CI) p-value BMI Normal weight (kg/m2) 1 (Ref) Overweight 0.514 (0.228–0.159) 0.11 Obese 1.812 (0.693–4.739) 0.2 hs-CRP Normal (< 3 mg/l) 1 (Ref) High (≥ 3 mg/l) 0.204 (0.069–0.602) 0.00 HOMA Normal (< 2.5) 1 (Ref) High (≥ 2.5) 2.982 (1.413–6.294) 0.00 hs-CRP, TG Normal CRP, normal TG 1 (Ref) High CRP, high TG 9.434 (1.753–50.778) 0.01 BMI, body mass index; hs-CRP, high-sensitivity C-reactive protein; HOMA, homeostatic model assessment; TG, triglycerides. Table 7. Multivariate regression analysis of MA with serum lipids and inflammatory markers in women after adjustment Variable Odds ratio (95% CI) p-value Age, years ≤ 39 1 (Ref) 40–59 0.930 (0.508–1.702) 0.81 ≥ 60 1.819 (1.008–3.283) 0.05 Hypertension Normotensives 1 (Ref) Hypertensive 1.321 (0.786–2.219) 0.29 Glucose Normal (< 5.6 mmol/l) 1 (Ref) High (≥ 5.6 mmol/l) 0.597 (0.356–0.976) 0.04 Insulin First quartile 1 (Ref) Last quartile 2.905 (1.436–5.877) 0.00
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