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A Comparison of the Prevalence of Metabolic Syndrome and Its Components in High and Low Altitude Populations in Peru

BACKGROUND Prevalence of the metabolic syndrome has been described in populations with ethnic and cultural differences. The aim of this study was to determine the prevalence of the metabolic syndrome on a population from the Andes Mountains of Peru and compare it to a sea-level population. METHODS A cross-sectional study of subjects aged 30 years old or more from the high-altitude population of San Pedro de Cajas (SPC) (13,450 feet) and the sea-level population of Rimac (331 feet) was done. The metabolic syndrome was identified according to the revised National Cholesterol Education Program definition. The prevalence of metabolic abnormalities was calculated by gender, age, and population. A multivariate analysis was done with metabolic syndrome as the dependant variable. RESULTS Ninety-nine subjects from SPC and 172 from Rimac were included. The prevalence of metabolic syndrome was higher in SPC (22.2% versus 16.9%; p = 0.28). Prevalence of hypertriglyceridemia was significantly higher in SPC (56.6% versus 29.7%; p < 0.001) and prevalence of high blood pressure was significantly higher in Rimac (30.8% versus 18.2%; p < 0.05). In the multivariate analysis female gender was a risk factor for metabolic syndrome (odds ratio [OR] = 4.2; 95% confidence interval [CI]: 1.76-9.15). CONCLUSIONS We found an overwhelming predominance of females with the metabolic syndrome in both populations due to high prevalences of abdominal obesity and low highdensity lipoprotein (HDL) Hypertriglyceridemia prevalence was elevated in both men and women of high altitude. Lower prevalence of high blood pressure and of high fasting glucose was found in the high-altitude natives. The prevalence and characteristics of the metabolic syndrome apparently varies among different ethnic groups and this indicates the need for more epidemiologic studies.

Prevalence of diabetes and impaired fasting glucose in Peru: report from PERUDIAB, a national urban population-based longitudinal study

Objectives We aimed to estimate the prevalences of diabetes and impaired fasting glucose (IFG) in a national sample in Peru and assess the relationships with selected sociodemographic variables. Methods We estimated prevalence in PERUDIAB study participants, a nationwide, stratified urban and suburban population selected by random cluster sampling. Between 2010 and 2012, questionnaires were completed and blood tests obtained from 1677 adults ≥25 years of age. Known diabetes was defined as participants having been told so by a doctor or nurse and/or receiving insulin or oral antidiabetic agents. Newly diagnosed diabetes was defined as fasting plasma glucose ≥126 mg/dL determined during the study and without a previous diabetes diagnosis. IFG was defined as fasting plasma glucose of 100–125 mg/dL. Results The estimated national prevalence of diabetes was 7.0% (95% CI 5.3% to 8.7%) and it was 8.4% (95% CI 5.6% to 11.3%) in metropolitan Lima. No gender differences were detected. Known and newly diagnosed diabetes prevalences were estimated as 4.2% and 2.8%, respectively. A logistic regression response surface model showed a complex trend for an increased prevalence of diabetes in middle-aged individuals and in those with no formal education. Diabetes prevalence was higher in coastal (8.2%) than in highlands (4.5%; p=0.03), and jungle (3.5%; p<0.02) regions. The estimated national prevalence of IFG was 22.4%, higher in males than in females (28.3% vs 19.1%; p<0.001), and higher in coastal (26.4%) than in highlands (17.4%; p=0.03), but not jungle regions (14.9%; p=0.07). Conclusions This study confirms diabetes as an important public health problem, especially for middle-aged individuals and those with no formal education. 40% of the affected individuals were undiagnosed. The elevated prevalence of IFG shows that nearly a quarter of the adult population of Peru has an increased risk of diabetes.

Prevalence of the metabolic syndrome in the mestizo population of peru.

BACKGROUND The metabolic syndrome (MS) has been shown to predict mortality due to cardiovascular disease. Currently, no population-based data on the prevalence of the MS is available in Peru. This study was aimed to assess the prevalence of the MS in urban Peruvian Mestizos, in the coastal districts of Lima, the capital of Peru. METHODS A cross-sectional, epidemiological survey was undertaken, including 612 unrelated subjects aged 30-92 years (68.3% females). Prevalence of the MS was defined by the National Cholesterol Education Program Expert Panel on Detection Evaluation, and Treatment of High Blood Cholesterol in Adults (ATPIII) criteria. Insulin resistance was estimated by the homeostasis model assessment (HOMA). RESULTS Age and sex standardized prevalence of the MS was 14.9% (13.2% in males, 16.5% in females). The MS was significantly more prevalent in females aged 45-59 years old (20.2% vs. 6.7%, p = 0.019). In individuals with the MS, the prevalence of insulin resistance (IR) was 45% in males/42% in females. Abdominal obesity (80% in males/92.8% in females), and low HDL cholesterol (55% males/75.4% females), but neither hypertriglyceridemia (85% in males/81.2% females) nor high fasting glucose (55% in males/36.2 % females) were more common in females. Prevalence of arterial hypertension was similar in both sexes. CONCLUSIONS In this Mestizo Peruvian population, prevalence of the MS is relatively low as compared to other ethnic groups; the higher prevalence in females is likely due to a higher prevalence of abdominal obesity. Overall, abdominal obesity and hypertriglyceridemia were the predominant combination of metabolic disorders in individuals fulfilling criteria for the diagnosis of the MS.

Elevated incidence rates of diabetes in Peru: report from PERUDIAB, a national urban population-based longitudinal study

Objective A recent report from a non-nationally representative, geographically diverse sample in four separate communities in Peru suggests an unusually high diabetes incidence. We aimed to estimate the national diabetes incidence rate using PERUDIAB, a probabilistic, national urban population-based longitudinal study. Research design and methods 662 subjects without diabetes, selected by multistage, cluster, random sampling of households, representing the 24 administrative and the 3 (coast, highlands and jungle) natural regions across the country, from both sexes, aged 25+ years at baseline, enrolled in 2010–2012, were followed for 3.8 years. New diabetes cases were defined as fasting blood glucose ≥126 mg/dL or on medical diabetes treatment. Results There were 49 cases of diabetes in 2408 person-years follow-up. The weighted cumulative incidence of diabetes was 7.2% while the weighted incidence rate was estimated at 19.5 (95% CI 13.9 to 28.3) new cases per 1000 person-years. Older age, obesity and technical or higher education were statistically associated with the incidence of diabetes. Conclusion Our results confirm that the incidence of diabetes in Peru is among the highest reported globally. The fast economic growth in the last 20 years, high overweight and obesity rates may have triggered this phenomenon.