CARDIOVASCULAR JOURNAL OF AFRICA • Volume 34, No 1, January–April 2023 26 AFRICA for those aged ≥ 60 years (AOR = 6.57, 96% CI: 1.57–27.54), while males had a lower risk of having the MetS. Discussion The aim of the study was to screen for cardiometabolic risk factors and their association with selected demographic and lifestyle variables among South African adults living in informal settlements. Our results show the presence of cardiometabolic risk factors (abdominal obesity, overweight/obesity, hypertension, and elevated cholesterol and glucose levels) that contributed to the presence of the MetS among participants, associated with several demographic and lifestyle variables. These findings are consistent with other studies conducted in the urban, peri-urban and rural settings in South Africa.18,19,30-33,36 Metabolic health screening is imperative to identify public health challenges and therapeutic targets to improve population health.19,56 The presence of abdominal obesity in this study, indicated by WC (46%), was lower compared to a study conducted among farm workers (56.4%)18 and rural and semi-urban communities (65.2%)19 in South Africa. However, abdominal obesity by WHtR (72%), observed in this study, was similar to other reports among South African adults (72.5%).19 The differences in abdominal obesity (WC and WHtR) by gender and age, observed in this study, are consistent with other South African studies.19,33 The literature documents that abdominal obesity often precedes the development of other cardiometabolic risk factors for the MetS and should be regarded as a vital component of cardiovascular risk evaluation in routine clinical practice, particularly, among females.19,57 In addition, a high prevalence of overweight/obesity (45%) was also observed in this study, with females being significantly more affected than males, as well as older participants more affected than younger participants. Increased overweight/obesity and variation of its presence in terms of age and gender have been reported in South Africa.44,58,59 The prevalence of hypertension was high in the current study (66%), and females and older participants were more affected compared to their counterparts. Disparities in the presence of hypertension by Table 4. Cardiometabolic risk factors and the MetS stratified by age Variables All n (%) < 35 years n (%) 35–59 years n (%) ≥ 60 years n (%) p-value Blood pressure Normal Hypertension 112 (34) 217 (66) 74 (39) 114 (61) 33 (30) 76 (70) 3 (15) 17 (85) 0.054* BMI Normal Underweight Overweight Obesity 172 (55) 6 (2) 76 (24) 66 (21) 108 (60) 5 (3) 38 (21) 30 (17) 51 (48) 0 26 (24) 30 (28) 7 (37) 0 6 (32) 6 (32) 0.052* WC Normal Abdominal obesity 86 (54) 73 (46) 63 (67) 31 (33) 19 (37) 32 (63) 3 (25) 9 (75) ≤ 0.0001* WHR Normal Abdominal obesity 116 (73) 43 (27) 83 (88) 11 (12) 28 (55) 23 (45) 4 (33) 8 (66) ≤ 0.0001* WHtR Normal Abdominal obesity 45 (28) 114 (72) 36(38) 58 (62) 8 (16) 43 (84) 1 (8) 11 (91) 0.004* Cholesterol Normal Elevated 136 (86) 23 (15) 85 (89) 10 (11) 41(80) 10 (20) 8 (73) 3 (27) 0.158 Glucose Normal Elevated 297 (93) 24 (7) 174 (97) 6 (3) 91 (85) 16 (15) 18 (90) 2 (10) 0.002* MetS No Yes 273 (83) 56 (17) 168 (90) 18 (10) 79 (72) 30 (28) 12 (60) 8 (40) ≤0.0001* BMI, body mass index; WC, waist circumference; WHR, waist–hip ratio; WHtR, waist-to-height ratio; SBP, systolic blood pressure; DBP, diastolic blood pressure; MetS, metabolic syndrome; n, number of participants; %, percentage. *Indicates significant difference. Table 5. Association of cardiometabolic risk factors with selected independent variables Variables AOR 95% CI p-value Abdominal obesity (by WC) Gender Female 1 [Reference] Male 0.11 0.05–0.25 ≤ 0.0001* Age (years) < 35 1 [Reference] 35–59 4.17 1.75–9.56 0.001* ≥ 60 4.52 0.86–23.69 0.074 Marital status Single 1 [Reference] Cohabiting 1.47 0.51–4.91 0.472 Married 3.02 1.19–7.64 0.020* Abdominal obesity (by WHtR) Gender Female 1 [Reference] Male 0.23 0.11–0.52 ≤ 0.0001* Age (years) < 35 1 [Reference] 35–59 2.79 1.09–7.16 0.033* ≥ 60 3.05 0.32–34.45 0.286 Marital status Single 1 [Reference] Cohabiting 1.08 0.37–3.11 0.967 Married 4.11 1.34–12.65 0.014* Hypertension Gender Female 1 [Reference] Male 1.42 0.88–2.28 0.149 Age (years) < 35 1 [Reference] 35–59 1.46 0.88–2.43 0.139 ≥ 60 3.78 1.06–13.42 0.040* AOR, adjusted odds ratio; Mets, metabolic syndrome; WC, waist circumference; WHtR, waist-to-height ratio. *Significant (p < 0.05). Table 6. Association of the MetS with selected independent variables MetS AOR 95% CI p-value Gender 1 [Reference] Female Male 0.42 0.20–0.90 0.026* Age (years) 1 [Reference] < 35 35–59 5.02 2.24–11.23 ≤ 0.0001* ≥ 60 6.57 1.57–7.54 0.010* Marital status 1 [Reference] Single Cohabiting 1.41 0.48–4.10 0.531 Married 1.96 0.82–4.66 0.129 AOR, adjusted odds ratio; MetS, metabolic syndrome. *Significant (p < 0.05).
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