Metabolic syndrome in Bantu subjects with type 2 diabetes from sub-Saharan extraction: Prevalence, gender differences and HOMA hyperbolic product

SummaryBackgroundMetabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) prevalence is increasing in developing countries as a result of urbanization, with widespread access to calorically richer foods. This cross-sectional study aimed at documenting MetS prevalence, the presence of its discrete components and the phenotypic characteristics including HOMA hyperbolic product of 1st generation sub-Saharan African migrants living in Belgium, and at comparing them to those of a reference white Caucasian autochthonous Belgian population with T2DM.Method337 Belgian patients were compared with 117 sub-Saharan African patients, all suffering from T2DM. In these two groups, we performed HOMA-modeling of insulin sensitivity (S) and β-cell function (β), as well the hyperbolic product (β × S), and we collected anthropometric and biochemical characteristics alongside the prevalence of MetS (NCEP ATP III), its components, and that of micro- and macro-vascular complications.ResultsIn the sub-Saharan group, waist circumference was lower, and the lipid profile showed higher HDL and lower triglycerides levels. This ensued a lower prevalence of categorical MetS in this population in male subjects. Diagnosis of T2DM occurred earlier in this sub-Saharan population, and while β × S was higher in those subjects compared with Caucasians, the demographics suggest that lifetime insulin secretion decreases faster in these otherwise less insulin-resistant subjects.ConclusionIn male sub-Saharan African subjects with T2DM, the MetS prevalence is lower than in sub-Saharan females, and lower than that recorded in Belgian diabetic subjects. This difference resulted from lower girth circumference and less atherogenic lipid profile. However, this sub-Saharan population had earlier onset diabetes with concurrent insulin resistance and earlier loss of insulin secretion.