Differential associations of cardio-metabolic diseases by population group, gender and adiposity in South Africa

Nasheeta Peer; Yusentha Balakrishna; Anniza de Villiers; Pamela Naidoo

doi:10.1371/journal.pone.0202899

Differential associations of cardio-metabolic diseases by population group, gender and adiposity in South Africa

PLoS One. 2018 Sep 27;13(9):e0202899. doi: 10.1371/journal.pone.0202899. eCollection 2018.

Authors

Nasheeta Peer^{1

2}, Yusentha Balakrishna³, Anniza de Villiers⁴, Pamela Naidoo^{5

6}

Affiliations

¹ Non-communicable Diseases Research Unit, South African Medical Research Council, Durban, South Africa.
² Department of Medicine, University of Cape Town, Cape Town, South Africa.
³ Biostatistics Unit, South African Medical Research Council, Durban, South Africa.
⁴ Non-communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.
⁵ Heart and Stroke Foundation South Africa, Cape Town, South Africa.
⁶ Stellenbosch University, Cape Town, South Africa.

Abstract

Aims: To describe the distribution and examine the associations of diabetes, hypertension and hypercholesterolaemia across and within population groups, gender and body mass index (BMI) categories.

Methods: This national cross-sectional study was conducted in 2013 among ≥18-year-old black African, coloured, white and Indian adults self-selected for screening. Data collection included self-reported behavioural risk factors and clinical measurements comprising blood pressure, anthropometry and point-of-care random blood glucose and cholesterol assessments.

Results: Among the 7711 participants, 2488 men and 5223 women, the prevalence of diabetes and hypertension increased by BMI category across population groups. Compared with white men and women, black African men (odds ratio: 2.66, 95% confidence interval: 1.70-4.16) and women (2.10, 1.49-2.96), coloured men (2.28, 1.44-3.60) and women (2.15, 1.52-3.05) and Indian men (4.38, 2.65-7.26) and women (3.64, 2.50-5.32) were significantly more likely to have diabetes. The odds for hypertension were significantly higher only in coloured men compared with white men (1.37, 1.02-1.83), while it was significantly higher in black African, coloured and Indian women compared with white women. The odds for hypercholesterolaemia were significantly lower in black African men (0.64, 0.49-0.84) and women (0.52, 0.43-0.62) compared with white men and women, and significantly higher in Indian men (1.47, 1.05-2.08) compared with white men. Black African women compared with their male counterparts were less likely to have diabetes (0.64, 0.46-0.89). Black African (0.66, 0.54-.082), coloured (0.65, 0.50-0.84) and white (0.69, 0.53-0.88) women were significantly less likely to have hypertension compared with their male counterparts. The odds for hypercholesterolaemia were higher in coloured (1.44, 1.16-1.80) and white (1.47, 1.18-1.84) women compared with their counterparts.

Conclusions: The cardio-metabolic diseases of diabetes, hypertension and hypercholesterolaemia were differentially associated with population groups and gender in South Africa. The insights obtained highlight the need for multi-disciplinary targeted management approaches in high-risk populations.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adiposity
Adult
Asian People
Black People
Cross-Sectional Studies
Diabetes Mellitus / epidemiology*
Female
Humans
Hypercholesterolemia / epidemiology*
Hypertension / epidemiology*
Male
Middle Aged
Obesity / complications
Obesity / epidemiology
Risk Factors
Sex Factors
South Africa / epidemiology
White People

Grants and funding

The HSFSA received funding from the National Lottery Board of South Africa and Pharma Dynamics to conduct their screening programme in 2013. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.