Prevalence of Metabolic Syndrome Amongst Canadian Aboriginals Attending a Screening Program                               ...
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Prevalence of metabolic syndrome amongst Canadian Aboriginals attending a screening program


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2005 (Nov) 3rd Annual World Congress on Insulin Resistence, poster presentation by BRAID Research

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Prevalence of metabolic syndrome amongst Canadian Aboriginals attending a screening program

  1. 1. Prevalence of Metabolic Syndrome Amongst Canadian Aboriginals Attending a Screening Program Ellen L. Toth MD, Tracy Connor BScN, Alison Meikle MSc, Shannon McEwen MSc Department of Medicine, University of Alberta email: Metabolic Syndrome Risk Factors in Adults Abstract Prevalence of the metabolic syndrome according The Metabolic Syndrome is a marker of cardiovascular risk that is a cause Defining Levelof increasing concern in many populations. In a population sample of adults in to the ATPIII definition Risk Factor (NCEP-ATP III) Normal At Risk Total Nthe USA white men and women showed 22 and 25% prevalence, whereas the a Obesity criteria adjusted to waist circumference appropriate for an Indian population.rates were higher for Mexican American men and women: 28 and 35%respectively. Less is known about Canadian populations. Country Age group (y) Reference Men Women The Mobile Diabetes Screening Initiative (MDSI) is an outreach effort to FBG ≥ 6.1mmol/L India 20–75 Deepa et al 36.4a 46.5a GLUCOSE 532 (93%) 37 (7%) 569detect and counsel regarding diabetes, pre-diabetes and their risk factors in or random > 11.1Aboriginal communities in Northern Alberta, Canada. Testing is done on Mexico 20–69 Aguilar-Salinas et al Total=26.6portable instruments with a rigorous QA program. 710 individuals haveattended to date, representing a “volunteer / concerned” sample of the Oman >20 Al-Lawati et al 19.5 23 BP ≥ 130/85 mm Hg 375 (66%) 190 (33%) 565population. Amongst 137 subjects previously known to have diabetes, Ireland 50–69 Villegas et al 21.8 21.5 TG ≥ 1.7mmol/L 131 (59%) 90 (41%) 221Metabolic Syndrome (NCEP/ATP III criteria) was demonstrated in 91%.Amongst 453 adults attending for screening, 31% prevalence was found in Turkey >31 Onat et al 27 38.6 HDLboth men and women. Increased waist circumference contributed to the Mauritius >24 Cameron et al 10.6a 14.7a Men < 1.0mmol/L 316 (66%) 252 (44%) 568diagnosis 96% of the time, with low HDL seen in 88%, hypertension in 74%, Women < 1.3mmol/Lhigh triglycerides in 51%, and abnormal glucose in 20%. France 30–64 Balkau et al 10 7 In the same group of subjects history of parental diabetes was seen in WAIST43%, 27% had siblings with diabetes, and 26% of the women had a history of USA (Native 45–49 Resnick et al 43.6 56.7 Americans) Men > 102 cm 274 (47%) 291 (52%) 566gestational diabetes. The prevalence of parental, sibling and gestationaldiabetes in the subjects with metabolic syndrome was 45%, 34%, and 25% Women > 88 cm USA (Filipina 50–69 Araneta et al — 34.3respectively. These figures indicate a concerned population with a high Americans) Clients withburden of illness. Screening of a larger, population based (Aboriginal) sample 3 or more risk factors/5 present 92 (50%) 91 (50%) 183is underway. complete data USA 30–79 Meigs et al 26.9 21.4 USA (Non-Hispanic 30–79 Meigs et al 24.7 21.3 FBG=Fasting Blood Glucose; BP=Blood Pressure; TG=Fasting Triglycerides; white) HDL=High Density Lipoprotein; Waist=Waist Circumference USA (Mexican 30–79 Meigs et al 29 32.8 Introduction American)• Cardiovascular disease, Type 2 diabetes, and Ethics obesity are more prevalent in Aboriginal peoples As we work with Aboriginal Peoples, special attention is required and will be paid to Results ownership, control, access, and possession (OCAP) of data that belongs to the• Type 2 diabetes is often accompanied and preceded by the metabolic syndrome people. This research is approached as a partnership with the communities and the Distribution of Patients with Complete Data by Age Group volunteers in the project.• The MDSi project’s mandate is to screen for diabetes and its complications in Aboriginal and 100 Limitations remote communities in Alberta, Canada a) Normal 90 •Data is collected in the communities that we work with, using a mobile team b) Metabolic Syndrome Methods 80 and portable technology.• Portable technology is used with a rigorous QA 70 •Subjects are concerned volunteers. protocol 60 Conclusion Percent• Subjects are Aboriginal volunteers from the 8 Métis settlements in Alberta, Canada 50 These results show that a high number of Canadian Aboriginals are at risk or have the• Procedures: History, risk questionnaire, 40 metabolic syndrome and further intervention and education is necessary. MDSi is anthropometrics, medications, fasting or random currently completing repeat visits (6 months after initial visits) with these Métis 30 glucose, A1c, lipids, and other measures are communities and have seen approximately 150 more clients. collected 20 REFERENCES Aguilar-Salinas CA, Rojas R, Gomez-Perez FJ, Valles V, Rios-Torres JM, Franco A, et al. Analysis of the agreement between the World Health Organization criteria and the• Analyses: metabolic syndrome, diabetes risk, and 10 National Cholesterol Education Program-III definition of the metabolic syndrome: results from a population-based survey. Diab Care 2003;26:1635. Al-Lawati JA, Mohammed AJ, Al-Hinai HQ, Jousilahti P. Prevalence of the metabolic syndrome among omani adults. Diab Care 2003;26:1781-5. predictors of diabetes are calculated Araneta MR, Wingard DL, Barrett-Connor E. Type 2 diabetes and metabolic syndrome in Filipina-American women: a high-risk non-obese population. Diab Care 2002;25:494-9. 0 Balkau B, Vernay M, Mhamdi L, Novak M, Arondel D, Vol S, et al. The incidence and persistence of the NCEP (National Cholesterol Education Program) metabolic syndrome. The French D.E.S.I.R. study. Diabet Metab 2003;29:526-32. 20-29 30-39 40-49 50-59 60-69 70-79 80-89 Cameron AJ, Shaw JE, Zimmet PZ, Chitson P, Alberti KGGM, Tuomilehto J. Comparison of WHO and NCEP metabolic syndrome definitions over 5 years in Mauritius. Diabetologia 2003;46:A3068. Deepa R, Shanthirani CS, Premalatha G, Sastry NG, Mohan V. Prevalence of insulin resistance syndrome in a selected south Indian population—the Chennai urban population Age Group study 7 (CUPS-7). Indian J Med Res 2002;115:118-27. Meigs JB, Wilson PW, Nathan DM, DAgostino Sr. RB, Williams K, Haffner SM. Prevalence and characteristics of the metabolic syndrome in the San Antonio Heart and Framingham Offspring Studies. Diabetes 2003;52:2160-7. Onat A, Ceyhan K, Basar O, Erer B, Toprak S, Sansoy V. Metabolic syndrome: major impact on coronary risk in a population with low cholesterol levels—a prospective and cross-sectional evaluation. Atherosclerosis 2002;165:285-92. Resnick HE. Metabolic syndrome in American Indians. Diab Care 2002;25:1246-7. Villegas R, Perry IJ, Creagh D, Hinchion R, OHalloran D. Prevalence of the metabolic syndrome in middle-aged men and women. Diab Care 2003;26:3198-9.