Association between Alanine Aminotransferase, Hypertension and Obesity in Nigerians.

BACKGROUND: Cardiovascular diseases (CVDs) are the leading causes of morbidity and mortality worldwide. Alanine aminotransferase (ALT) is associated with hypertension and obesity. OBJECTIVES: To determine the association between ALT within the reference range with hypertension and obesity. METHODS: This study utilized the data of a cross-sectional health survey involving 558 adult participants. Anthropometry, blood pressure, and plasma glucose were determined with standard protocols. Quartiles of log-transformed ALT were generated and the association with obesity/hypertension was determined with ANOVA and regression analysis. RESULTS: There were 205 (36.7%) men. The mean fasting plasma glucose (FPG) of all participants was 4.7 (1.6) mmol/L. In men, there was a positive correlation between ALT and body mass index (BMI) (r=0.148; p=0.038), waist circumference (WC) (r=0.166; p=0.020), and waist-to-height-ratio (WHtR) (r=0.163; p=0.021). No correlation was observed between ALT and anthropometric indices in women, or with blood pressure indices in both genders. In men, only WHtR (p for trend, 0.045) was significantly associated with ALT quartiles, whereas in women, only WC (p for trend, 0.028) was significantly associated with ALT quartiles. In men, compared to 1st quartile, the OR for general obesity of the 4th quartile of Log ALT was 2.662 (95% CI 1.219 - 5.816; p=0.014). In women, the OR for hypertension of the 3rd quartile of Log ALT versus the 1st quartile was 1.955 (95% CI 0.694 - 2.416; p=0.041). Log ALT did not predict hypertension and obesity in men and women, respectively. CONCLUSIONS: The risks of obesity and hypertension increase as the ALT level increases within the normal ALT range. People with normal levels of ALT in the upper limits need to be evaluated for metabolic disorders.

CONTEXTE: Les maladies cardiovasculaires (MCV) sont des causes principales de morbidité et de mortalité dans le monde. L'alanine aminotransférase (ALT) est associée à l'hypertension et à l'obésité. OBJECTIFS: Déterminer l'association entre l'ALT dans la plage de référence avec l'hypertension et l'obésité. MÉTHODES: Cette étude utilise les données d'une enquête transversale sur la santé impliquant 558 participants adultes. L'anthropométrie, la pression artérielle et la glycémie plasmatique ont été déterminées selon des protocoles standard. Les quartiles de l'ALT transformée en logarithme ont été générés et son association avec l'obésité/l'hypertension a été déterminée avec une analyse de variance (ANOVA) et une analyse de régression. RÉSULTATS: Il y avait 205 hommes (36,7%). La glycémie plasmatique à jeun moyenne (FPG) de tous les participants était de 4,7 (1,6) mmol/L. Chez les hommes, il y avait une corrélation positive entre l'ALT et l'indice de masse corporelle (IMC) (r=0,148, p<0,038), la circonférence de taille (CT) (r=0,166, p<0,020) et le rapport tour de taille/taille (WHtR) (r=0,163, p<0,021). Aucune corrélation n'a été observée entre l'ALT et les indices anthropométriques chez les femmes, ni entre les indices de pression artérielle dans les deux sexes. Chez les hommes, seul le WHtR (p pour la tendance, 0,045) était significativement associé aux quartiles de l'ALT, tandis que chez les femmes, seule la CT (p pour la tendance, 0,028) était significativement associée aux quartiles de l'ALT. Chez les hommes, par rapport au 1er quartile, le rapport de cotes (RC) pour l'obésité générale du 4ème quartile de Log ALT était (2,662, IC à 95%, 1,219-5,816; p=0,014). Chez les femmes, le RC pour l'hypertension du 3ème quartile de Log ALT versus le 1er quartile était (1,955, IC à 95%, 0,694-2,416; p=0,041). Le Log ALT n'a pas prédit l'hypertension et l'obésité chez les hommes et les femmes respectivement. CONCLUSIONS: Le risque d'obésité et d'hypertension augmente à mesure que le niveau d'ALT augmente dans la plage normale d'ALT. Les personnes présentant un niveau normal d'ALT aux limites supérieures doivent être évaluées pour des troubles métaboliques. MOTS-CLÉS: Maladies cardiovasculaires, Obésité, Hypertension, Alanine aminotransferase.

Knowledge and Prevalence of Heart Disease Risk Factors Among Staff of a Tertiary Institution in Nigeria.

BACKGROUND: Cardiovascular disease is the most common cause of mortality worldwide. Hence, awareness of cardiovascular risk factors is an essential step towards effective reduction of the disease burden. This study determined the knowledge and prevalence of cardiovascular risk factors among Staff of Ekiti State University. Ado-Ekiti, Nigeria. METHODS: A cross-sectional study which comprised of 223 members of staff. RESULTS: There were 103 males (46.2%). Low knowledge of heart disease risk factors was found in 68.6% of the respondents. The prevalence of hypertension, diabetes mellitus, overweight, obesity, physical inactivity was 35.4%, 12.1%, 31.8%, 23.3%, and 83% respectively. Family history of hypertension was a predictor of a high level of knowledge. CONCLUSION: A low level of knowledge and increasing prevalence of cardiovascular risk factors existed among staff of Ekiti State University, Nigeria. Hence, there should be a step-up of awareness campaigns and promotion of healthy lifestyle among this category of people.

Deriving an optimal threshold of waist circumference for detecting cardiometabolic risk in sub-Saharan Africa.

BACKGROUND: Waist circumference (WC) thresholds derived from western populations continue to be used in sub-Saharan Africa (SSA) despite increasing evidence of ethnic variation in the association between adiposity and cardiometabolic disease and availability of data from African populations. We aimed to derive a SSA-specific optimal WC cut-point for identifying individuals at increased cardiometabolic risk. METHODS: We used individual level cross-sectional data on 24 181 participants aged ⩾15 years from 17 studies conducted between 1990 and 2014 in eight countries in SSA. Receiver operating characteristic curves were used to derive optimal WC cut-points for detecting the presence of at least two components of metabolic syndrome (MS), excluding WC. RESULTS: The optimal WC cut-point was 81.2 cm (95% CI 78.5-83.8 cm) and 81.0 cm (95% CI 79.2-82.8 cm) for men and women, respectively, with comparable accuracy in men and women. Sensitivity was higher in women (64%, 95% CI 63-65) than in men (53%, 95% CI 51-55), and increased with the prevalence of obesity. Having WC above the derived cut-point was associated with a twofold probability of having at least two components of MS (age-adjusted odds ratio 2.6, 95% CI 2.4-2.9, for men and 2.2, 95% CI 2.0-2.3, for women). CONCLUSION: The optimal WC cut-point for identifying men at increased cardiometabolic risk is lower (⩾81.2 cm) than current guidelines (⩾94.0 cm) recommend, and similar to that in women in SSA. Prospective studies are needed to confirm these cut-points based on cardiometabolic outcomes.International Journal of Obesity advance online publication, 31 October 2017; doi:10.1038/ijo.2017.240.

Obesity; overweight; and underweight among urban Nigerians

Background: Disease burden from communicable and noncommunicable diseases is a significant health challenge facing many developing nations. Among the noncommunicable diseases; is obesity; which has become a global epidemic associated with urbanization. Objective: The aim was to evaluate the prevalence of weight abnormalities; their pattern of distribution and regional differences among apparently healthy urban dwelling Nigerians. Methods: A cross-sectional community-based descriptive survey was carried out in five urban cities; each from one geo-political zone of Nigeria. Multistage sampling procedures were used to select participants using the World Health Organization STEPS instrument. Ethical approval and consents were duly and respectively obtained from the Ethics Committee in the tertiary centers and participants in each of these cities. Analysis was performed using SPSS version 20 (IBM Corp.; Amonk; NY; released 2011) with P value set at 0.05. Results: A total of 5392 participants were recruited; of which; 54.5 and 45.5 were males and females respectively. Mean (standard deviation) age and body mass index (BMI) were 40.6 (14.3) years and 25.3 (5.1) kg/m 2 . Obesity; overweight; and underweight were found in 17; 31; and 5 of participants respectively. Significantly; while underweight declined with increasing age; overweight; and obesity increased to peak in the middle age brackets. Age of ? 40 years was found to confer about twice the risk of becoming overweight. The prevalence of obesity and mean BMI were significantly higher both among the females and the participants from southern zones. Conclusion: Obesity and overweight are common in our urban dwellers with accompanying regional differences. Attainment of middle age increases the likelihood of urban dwelling Nigerians to become overweight/obese. There is therefore the need to institute measures that will check development of overweight/obesity early enough; while improving the nutritional status of the few who may still be undernourished

Obesity, overweight, and underweight among urban Nigerians.

BACKGROUND: Disease burden from communicable and noncommunicable diseases is a significant health challenge facing many developing nations. Among the noncommunicable diseases, is obesity, which has become a global epidemic associated with urbanization. OBJECTIVE: The aim was to evaluate the prevalence of weight abnormalities, their pattern of distribution and regional differences among apparently healthy urban dwelling Nigerians. METHODS: A cross-sectional community-based descriptive survey was carried out in five urban cities, each from one geo-political zone of Nigeria. Multistage sampling procedures were used to select participants using the World Health Organization STEPS instrument. Ethical approval and consents were duly and respectively obtained from the Ethics Committee in the tertiary centers and participants in each of these cities. Analysis was performed using SPSS version 20 (IBM Corp., Amonk, NY; released 2011) with P value set at < 0.05. RESULTS: A total of 5392 participants were recruited; of which, 54.5% and 45.5% were males and females respectively. Mean (standard deviation) age and body mass index (BMI) were 40.6 (14.3) years and 25.3 (5.1) kg/m 2 . Obesity, overweight, and underweight were found in 17%, 31%, and 5% of participants respectively. Significantly, while underweight declined with increasing age, overweight, and obesity increased to peak in the middle age brackets. Age of ≥ 40 years was found to confer about twice the risk of becoming overweight. The prevalence of obesity and mean BMI were significantly higher both among the females and the participants from southern zones. CONCLUSION: Obesity and overweight are common in our urban dwellers with accompanying regional differences. Attainment of middle age increases the likelihood of urban dwelling Nigerians to become overweight/obese. There is therefore the need to institute measures that will check development of overweight/obesity early enough, while improving the nutritional status of the few who may still be undernourished.

Community based diabetes risk assessment in Ogun state, Nigeria (World Diabetes Foundation project 08-321).

OBJECTIVE: The study assessed the risk of developing type 2 diabetes Mellitus in Ogun State, Nigeria. MATERIALS AND METHODS: Finnish Medical Association diabetes risk score was administered across 25 communities facilitated by non-communicable disease clinics established under a World Diabetes Foundation project. Subjects in the high risk group had blood glucose estimated. RESULTS: 58,567 respondents included 34,990 (59.6%) females and 23,667 (40.3%) males. Majority (61.2%) were between 25 years and 54 years. Considering waist circumference, 34,990 (38.1%) females and 23,667 (5.3%) males had values above 88 cm and 102 cm respectively. Overall, 11,266 (19.2%) were obese and 28.9% overweight using body mass index (BMI). More females had elevated BMI than males. Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of all subjects were 129.54 mm Hg ± 23.5 mm Hg and 76.21 mm Hg ± 15.5 mm Hg respectively. Prevalence of hypertension (Joint National Committee VII classification) was 27.7%. More subjects had normal DBP than SBP (68.2% vs. 42.5% P < 0.05). Mean fasting blood glucose (FBG) of all subjects was 5.5 mmol/L ± 0.67 mmol/L. Using a casual blood glucose >11.1 mmol/L and/or FBG >7 mmol/L, the total yield of subjects adjudged as having diabetes was 2,956 (5.05%). Mean total risk score was 5.60 ± 3.90; this was significantly higher in females (6.34 ± 4.16 vs. 4.24 ± 3.71, P < 0.05). A total of 2,956 (5.05%) had high risk of developing DM within 10 years. CONCLUSION: The risk of developing DM is high in the community studied with females having a higher risk score. There is urgent need to implement diabetes prevention strategies.

Correlates of cardiac autonomic neuropathy in Nigerian patients with type 2 diabetes mellitus.

Cardiac Autonomic Neuropathy (CAN) contributes significantly to increased cardiovascular morbidity and mortality in type2 diabetic patients. This manuscript aims to study the prevalence of CAN in T2DM patients in our environment and identify factors that correlate with and predict development of CAN. This is with the intention to prevent and intervene in these factors. One hundred and eight (108) T2DM patients were screened and investigated by the standard six non-invasive tests including heart rate variability, QTc and Valsalva manouvre. Patients who had abnormality in more than 2 of the tests were adjudged to have CAN. They were statistically compared with those without CAN. Thirty- seven (34.2%) patients had CAN. The commonest abnormality was in heart rate response to standing (76.9%) There was no significant difference in the mean age and sex of those with CAN and those without. Though significantly more males had CAN, when sex was entered into the logistic regression it did not correlate with CAN. Poor short-term glycaemic control as demonstrated by fasting blood glucose (130.87 + 56.1 vs 94.24 + 48.9 mg%, p < 0.05); serum creatinine (1.23 + 0.52 vs 0.86 + 0.39 mg%, p<0.05), presence of hypertension and first degree family history were significantly more in patients with CAN. There was more than 2-fold increased risk of developing CAN when serum creatinine was greater than 1.5 mg% (OR 2.013, 95% CI 0.543-2.657) and when FBG was more than 120 mg% (OR 2.106, 95% CI 0.834-2.897). CAN is common in our patients with T2DM. It is more prevalent in those with hypertension, first degree family history and renal damage. Poor short-time glycaemic control was also a contributory factor.

Reiter's syndrome--a case report and review of literature.

The occurrence of Reiter's Syndrome is rare and not commonly reported in Nigeria. This paper reports a case of a 35 yr old male Nigerian with Reiter's Syndrome, occurring 1-2 weeks after a bout of a dysenteric illness. The patient presented with fever, conjunctivitis, dysentery, urethritis and arthralgia. The joint pains involved the left wrist (which was swollen), the right knee and ankle joints. The patient was managed conservatively. The case is presented with a view to documenting the occurrence of Reiter's Syndrome in an African Nigerian.