Diabetes mellitus hypertension and related factors in black subjects residing in Qwaqwa and Bloemfontein

[摘要] English: BACKGROUNDThe black population of South Africa underwent rapid urbanisation during the last century.This process was accompanied by major changes in lifestyle including less physical activity,the moving away from traditional low-fat diets to diets high in saturated fat, and the acquiringof unhealthy habits such as the smoking of cigarettes. Previously rare chronic diseases oflifestyle such as diabetes mellitus, hypertension, obesity, dyslipidaemia and atheroscleroticcardiovascular disease started to emerge during this period.AIMSThe primary aims of the study were to determine the prevalence of diabetes mellitus,hypertension, obesity, and dyslipidaemia, in a partly rural and an urban black community.The secondary objectives were to investigate the hypotheses that the metabolic syndromeexisted in the black population and that hypertension was associated with hyperinsulinaemiain the study populations.STUDY DESIGNA cross-sectional studySETTING:The study was conducted in the semi-rural area of Qwaqwa and in Mangaung, the main blackresidential area of Bloemfontein.METHODSA representative sample of 853 subjects 25 years and older (279 males and 574 females) wasselected from Qwaqwa, a partly rural community in the Free State, and a similar sample of758 subjects (290 males and 468 females) from Mangaung, the black residential area ofBloemfontein, as the urban sample for comparison. After informed consent, the prevalence ofthe following conditions was determined according to standardised procedures: diabetesmellitus, impaired glucose tolerance, impaired fasting glucose, hypertension, dyslipidaemia,and overweight and obesity. In addition, anthropornetrlcal measurements including themeasurement of selected skinfold thickness and body circumferences were measured. A 12-lead resting electrocardiograph was obtained from each subject and blood specimens werecollected for the measurement of insulin, proinsulin and C-peptide. A trained nurseadministered a questionnaire to each respondent in his or her own language to obtaindemographic and biosocial information.RESULTSThe response rates were 68% in Qwaqwa and 62% in Mangaung. The age-standardisedprevalence rates for the chronic diseases that were studied, are provided in the Table 51.Table A1 will be attached on the full document.The prevalence rates of the risk factors that were studied did not differ significantly betweenthe Qwaqwa and Mangaung samples. Although the metabolic syndrome was present in 31% ofsubjects in both samples, no electrocardiographic evidence of an increased prevalence ofcoronary heart disease was found in subjects with the metabolic syndrome. Hyperinsulinaemiaand thus insulin resistance was not associated with hypertension in any of these two blackpopulations with a high prevalence of obesity and hypertension. It is unlikely that a populationwith such a clustering of cardiovascular risk factors can much longer escape the emergence ofcoronary artery disease as an important public health problem.CONCLUSIONThe black populations of Qwaqwa and Mangaung are well advanced on the raad ofurbanisation and the nutrition transition. Chronic diseases of lifestyle are as prevalent in thesecommunities as elsewhere in the Western world. Coronary artery disease is usually the last ofthe typical Western diseases to emerge in a population in transition and it is unlikely thatthese black populations will escape this disease much longer.

[发布机构] University of the Free State