Metabolic syndrome, associated factors and optimal waist circumference cut points: findings from a cross-sectional community-based study in the elderly population in Asmara, Eritrea

OBJECTIVE: The aim of the study was to investigate the prevalence of metabolic syndrome (MetSyn), associated factors, and optimal waist circumference (WC) cut points in a subset of the elderly population in Asmara, Eritrea. DESIGN: A community-based cross-sectional study conducted between January and June 2018. SETTING: Asmara, Eritrea. PARTICIPANTS: Demographic, clinical biochemistry and anthropometric information were collected from a total of 319 elderly participants of African lineage (54.5% men vs 45.5% women). MAIN OUTCOME MEASURES: Lipid profiles, fasting plasma glucose (FPG), anthropometric data, clinical profiles and demographic characteristic of patients were described. MetSyn was defined according to the International Diabetes Federation harmonised criteria. RESULTS: The median age (IQR) of study participants was 67 (IQR: 63–72 years)—men 68 (IQR: 64–74) years versus women 65 (IQR: 62–70) years, p=0.002. The prevalence of MetSyn was 90 (28.4%). Abnormal values in MetSyn components were as follows: systolic blood pressure/diastolic blood pressure ≥130/85 mm Hg or use of hypertension medication 133 (41.7%); overweight/obesity, 55 (25.1%); abdominal obesity 129 (40.4); low-density lipoproptein cholesterol (LDL-C) >130 mg/dL, 139 (43.6%); total cholesterol >200 mg/dL, 152 (47.6%); non-high-density lipoproptein cholesterol (HDL-C)>130 mg/dL, 220 (69.0%) and FPG (≥100–125 mg/dL), 35 (12.7%) and FPG>125.17 (6.2%). Multivariate logistic regression analysis indicated that sex (females) (adjusted OR (aOR) 4.69, 95% CI 2.47 to 8.92); non-HDL-C (aOR 1.09, 95% CI 1.05 to 1.14); LDL-C >130 mg/dL (aOR 2.63, 95% CI 1.09 to 6.37) and body mass index (aOR 1.20, 95% CI 1.10 to 1.32) were independently associated with the presence of MetSyn. Optimal cut points for WC in men yielded a value of 85.50 cm, a sensitivity of 76.0%, a specificity of 61.0% and an area under receiver operating characteristics curve (AUROC) value of 74.0, 95% CI (65.7 to 82.4). For women, the WC at a cut point value of 80.50 cm yielded the highest Youden index (0.41) with a sensitivity of 80%, a specificity of 39%, and an AUROC of 73.4, 95% CI (64.8 to 82.5). CONCLUSIONS: The MetSyn is highly prevalent in a subset of apparently healthy elderly population in Asmara, Eritrea. The findings support opportunistic and/or programmatic screening for CVD risk in the elderly during outpatient visits.