CARDIOVASCULAR JOURNAL OF AFRICA • Volume 33, No 5, September/October 2022 240 AFRICA study design, we could not establish causality or temporality of events, and obtained at least three positive results a month apart, before a definite diagnosis, which requires a longitudinal study design. Nevertheless, we believe that the present study sheds light on the levels of MA in urine and it quantified MA among a presumably healthy black population. Furthermore, it determined the association of MA with inflammatory markers and serum lipids in a rural DHDSS site in South Africa. The results of this study cannot be generalised to other areas in South Africa, since this site is a very small rural area in one specific province and the situation may vary considerably in urban areas or with different racial populations. The reliability and validity measures for anthropometric measurements were not calculated in this study, so results are to be interpreted with caution. Conclusion Substantial proportions of MA, hypertension, insulin resistance, overweight and obesity, as well as high levels of serum lipids and inflammatory markers were observed in the population. Independently, serum lipids and inflammatory markers showed no association with MA in this population. However, MA was associated with high hs-CRP and TG levels among men. We recommend in this population, participants should be screened for serum lipids, especially TG, and CRP and insulin sensitivity, and those with high TG and CRP levels, and insulin resistance should then be screened for MA, as the odds of them having MA are increased. There is a need for studies that will determine the association of MA, serum lipids and inflammatory markers while diagnosing MA with at least three urine samples over three months. We thank the population of Dikgale HDSS site in South Africa for participating in the study. 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