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Horm Metab Res 2009; 41(2): 75-78
DOI: 10.1055/s-0028-1082038
Review

© Georg Thieme Verlag KG Stuttgart · New York

Metabolic Syndrome in Africa: An Emerging Perspective

H. C. Onyegbutulem 1 , 2 , P. I. H-Onyegbutulem 1 , M. Reimann 2 , J. Li 2 , S. R. Bornstein 2 , P. E. Schwarz 2
  • 1The Asokoro Hospital Abuja, Abuja, Nigeria
  • 2Clinic of Internal Medicine III, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
Further Information

Publication History

received 10.05.2008

accepted 04.06.2008

Publication Date:
17 September 2008 (online)

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Abstract

The high prevalence of human immunodeficiency virus infection and the emergence of HIV-related metabolic syndrome from its successful treatment in African countries are discussed. The classical factors fuelling metabolic syndrome as well as the role of urbanization are considered in this review. The future impact of ongoing conflicts and famine in large parts of Africa on the burden of metabolic syndrome in this region is given some attention. The current pattern of metabolic syndrome in Africa may be modified to an even more distinct form, far from that seen elsewhere.

Key words

HIV treatment - urbanization - metabolic risk

References

  • 1 Kahn R, Buse J, Ferrannini E, Stern M. The metabolic syndrome: time for a critical appraisal. Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes.  Diabetologia. 2005;  48 1684-1699
    CrossrefPubMedGoogle Scholar
  • 2 Hanefeld M, Ceriello A, Schwarz PE, Bornstein SR. The challenge of the metabolic syndrome.  Horm Metab Res. 2007;  39 625-626
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Schwarz PE, Reimann M, Li J, Bergmann A, Licinio J, Wong ML, Bornstein SR. The metabolic syndrome – a global challenge for prevention.  Horm Metab Res. 2007;  39 777-780
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Korenblum W, Barthel A, Licinio J, Wong ML, Wolf OT, Kirschbaum C, Bornstein SR. Elevated cortisol levels and increased rates of diabetes and mood symptoms in Soviet Union-born Jewish immigrants to Germany.  Mol Psychiatry. 2005;  10 974-975
    CrossrefPubMedGoogle Scholar
  • 5 Bornstein SR, Schuppenies A, Wong ML, Licinio J. Approaching the shared biology of obesity and depression: the stress axis as the locus of gene-environment interactions.  Mol Psychiatry. 2006;  11 892-902
    CrossrefPubMedGoogle Scholar
  • 6 Schuppenies A, Schwarz P, Bornstein SR. Seasonal affective disorder and HPA axis disturbance.  Horm Metab Res. 2006;  38 434
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Reimann M, Schutte AE, Schwarz PE. Insulin resistance – the role of ethnicity: evidence from Caucasian and African cohorts.  Horm Metab Res. 2007;  39 853-857
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Alberti KG, Zimmet P, Shaw J. International Diabetes Federation: a consensus on Type 2 diabetes prevention.  Diabet Med. 2007;  24 451-463
    CrossrefPubMedGoogle Scholar
  • 9 Kamari Y, Grossman E, Oron-Herman M, Peleg E, Shabtay Z, Shamiss A, Sharabi Y. Metabolic stress with a high carbohydrate diet increases adiponectin levels.  Horm Metab Res. 2007;  39 384-388
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Schwarz PE. Congress report from the American Diabetes Association 66th Annual Scientific Sessions in Washington, USA.  Exp Clin Endocrinol Diabetes. 2006;  114 605-610
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Hanefeld M, Ceriello A, Schwarz PE, Bornstein SR. The metabolic syndrome – a postprandial disease?.  Horm Metab Res. 2006;  38 435-436
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Mutimura E, Crowther NJ, Stewart A, Todd Cade W. The human immunodeficiency virus and the cardiometabolic syndrome in the developing world: an African perspective.  J Cardiometab Syndr. 2008;  3 106-110
    CrossrefPubMedGoogle Scholar
  • 13 Schuster DP, Gaillard T, Osei K. The cardiometabolic syndrome in persons of the African diaspora: challenges and opportunities.  J Cardiometab Syndr. 2007;  2 260-266
    CrossrefPubMedGoogle Scholar
  • 14 Schwarz PE, Peltonen M. Prevention of type 2 diabetes – lessons we have learnt for implementation.  Horm Metab Res. 2007;  39 636-641
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Sainaghi PP, Castello L, Bergamasco L, Carnevale Schianca GP, Bartoli E. Metabolic characteristics of glucose intolerance: the critical role of obesity.  Exp Clin Endocrinol Diabetes. 2008;  116 86-93
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Schwarz PE, Towers GW, Fischer S, Govindarajalu S, Schulze J, Bornstein SR, Hanefeld M, Vasseur F. Hypoadiponectinemia is associated with progression toward type 2 diabetes and genetic variation in the ADIPOQ gene promoter.  Diabetes Care. 2006;  29 1645-1650
    CrossrefPubMedGoogle Scholar
  • 17 Puepet FH, Ohwovoriole AE. Prevalence of risk factors for diabetes mellitus in a non-diabetic population in Jos, Nigeria.  Niger J Med. 2008;  17 71-74
    PubMedGoogle Scholar
  • 18 Alebiosu CO, Odusan BO. Metabolic syndrome in subjects with type-2 diabetes mellitus.  J Natl Med Assoc. 2004;  96 817-821
    PubMedGoogle Scholar
  • 19 Fezeu L, Balkau B, Kengne AP, Sobngwi E, Mbanya JC. Metabolic syndrome in a sub-Saharan African setting: central obesity may be the key determinant.  Atherosclerosis. 2007;  193 70-76
    CrossrefPubMedGoogle Scholar
  • 20 Isezuo SA, Ezunu E. Demographic and clinical correlates of metabolic syndrome in native African type-2 diabetic patients.  J Natl Med Assoc. 2005;  97 557-563
    PubMedGoogle Scholar
  • 21 Mbanya JC, Ngogang J, Salah JN, Minkoulou E, Balkau B. Prevalence of NIDDM and impaired glucose tolerance in a rural and an urban population in Cameroon.  Diabetologia. 1997;  40 824-829
    CrossrefPubMedGoogle Scholar
  • 22 Njelekela MA, Negishi H, Nara Y, Sato T, Tomohiro M, Kuga S, Noguchi T, Kanda T, Yamori M, Mashalla Y, Liu LJ, Ikeda K, Mtabaji J, Yamori Y. Obesity and lipid profiles in middle aged men and women in Tanzania.  East Afr Med J. 2002;  79 58-64
    PubMedGoogle Scholar
  • 23 Schutte AE, Huisman HW, Schutte R, Malan L, Rooyen JM van, Malan NT, Schwarz PE. Differences and similarities regarding adiponectin investigated in African and Caucasian women.  Eur J Endocrinol. 2007;  157 181-188
    CrossrefPubMedGoogle Scholar
  • 24 WHO: . , 2006 report on the Global AIDS epidemic, http://www.who.int/hac/donorinfo/cap/west_africa_cap_inside_eng_.pdf , In WHO (ed), 2006
  • 25 James JS. Bush proposes near tripling of U.S. commitment on global HIV epidemic.  AIDS Treat News. 2003;  6-8
    PubMedGoogle Scholar
  • 26 Salehian B, Bilas J, Bazargan M, Abbasian M. Prevalence and incidence of diabetes in HIV-infected minority patients on protease inhibitors.  J Natl Med Assoc. 2005;  97 1088-1092
    PubMedGoogle Scholar
  • 27 Pearson TL, Pronk NP, Tan AW, Halstenson C. Identifying individuals at risk for the development of type 2 diabetes mellitus.  Am J Man Care. 2003;  9 57-66
    PubMedGoogle Scholar
  • 28 Bakari AG, Sani-Bello F, Shehu MS, Mai A, Aliyu IS, Lawal II. Anti-retroviral therapy induced diabetes in a Nigerian.  Afr Health Sci. 2007;  7 133-135
    PubMedGoogle Scholar
  • 29 Spiegel PB, Bennedsen AR, Claass J, Bruns L, Patterson N, Yiweza D, Schilperoord M. Prevalence of HIV infection in conflict-affected and displaced people in seven sub-Saharan African countries: a systematic review.  Lancet. 2007;  369 2187-2195
    CrossrefPubMedGoogle Scholar
  • 30 Ntyintyane LM, Panz VR, Raal FJ, Gill GV. Metabolic syndrome, undiagnosed diabetes mellitus and insulin resistance are highly prevalent in urbanised South African blacks with coronary artery disease.  Cardiovasc J S Afr. 2006;  17 50-55
    PubMedGoogle Scholar
  • 31 Amoah AG. Undiagnosed diabetes and impaired glucose regulation in adult Ghanaians using the ADA and WHO diagnostic criteria.  Acta Diabetol. 2002;  39 7-13
    CrossrefPubMedGoogle Scholar
  • 32 Diamantopoulos EJ, Andreadis EA, Tsourous GI, Ifanti GK, Katsanou PM, Georgiopoulos DX, Vassilopoulos CV, Dimitriadis G, Raptis SA. Metabolic syndrome and prediabetes identify overlapping but not identical populations.  Exp Clin Endocrinol Diabetes. 2006;  114 377-383
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Wenying Y, Zhaojun Y. Obesity and hypertension as two anthropometric predictors for metabolic syndrome.  Horm Metab Res. 2006;  38 469-470
    Article in Thieme ConnectPubMedGoogle Scholar
  • 34 Lamounier-Zepter V, Ehrhart-Bornstein M, Bornstein SR. Metabolic syndrome and the endocrine stress system.  Horm Metab Res. 2006;  38 437-441
    Article in Thieme ConnectPubMedGoogle Scholar
  • 35 Sobngwi E, Mbanya JC, Unwin NC, Kengne AP, Fezeu L, Minkoulou EM, Aspray TJ, Alberti KG. Physical activity and its relationship with obesity, hypertension and diabetes in urban and rural Cameroon.  Int J Obes Relat Metab Disord. 2002;  26 1009-1016
    CrossrefPubMedGoogle Scholar
  • 36 Schwarz PE, Schwarz J, Schuppenies A, Bornstein SR, Schulze J. Development of a diabetes prevention management program for clinical practice.  Public Health Rep. 2007;  122 258-263
    CrossrefPubMedGoogle Scholar
  • 37 Fezeu L, Minkoulou E, Balkau B, Kengne AP, Awah P, Unwin N, Alberti GK, Mbanya JC. Association between socioeconomic status and adiposity in urban Cameroon.  Int J Epidemiol. 2006;  35 105-111
    PubMedGoogle Scholar
  • 38 Levitt NS, Lambert EV. The foetal origins of the metabolic syndrome – a South African perspective.  Cardiovasc J S Afr. 2002;  13 179-180
    PubMedGoogle Scholar
  • 39 Schwarz PE, Towers GW, Merwe A van der, Perez-Perez L, Rheeder P, Schulze J, Bornstein SR, Licinio J, Wong ML, Schutte AE, Olckers A. Global meta-analysis of the C-11377G alteration in the ADIPOQ gene indicates the presence of population-specific effects: challenge for global health initiatives.  Pharmacogenomics J. 2008;  , [Epub ahead of print]
    PubMedGoogle Scholar
  • 40 James WP. The epidemiology of obesity: the size of the problem.  J Intern Med. 2008;  263 336-352
    CrossrefPubMedGoogle Scholar
  • 41 Kuartei S. Environment and expression of the thrifty genes.  Pac Health Dialog. 2005;  12 105-109
    PubMedGoogle Scholar
  • 42 Yajnik CS. The insulin resistance epidemic in India: fetal origins, later lifestyle, or both?.  Nutr Rev. 2001;  59 1-9
    PubMedGoogle Scholar
  • 43 Rooyen JM, Pretorius PJ, Britz M, Huisman HW, Schutte AE, Towers GW, Olckers A, Schwarz PE, Malan NT, Malan L, Schutte R. Genetic polymorphisms of beta2- and beta3-Adrenergic receptor genes associated with characteristics of the metabolic syndrome in black South African women.  Exp Clin Endocrinol Diabetes. 2008;  116 236-240
    Article in Thieme ConnectPubMedGoogle Scholar

Correspondence

Dr. P. E. Schwarz

Division of Endocrinology

Department of Medicine III

Medical Faculty Carl-Gustav-Carus

Technical University Dresden

01307 Dresden

Germany

Phone: +49/351/458 27 15

Fax: +49/351/458 73 19

Email: peter.schwarz@uniklinikum-dresden.de

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