Metabolic Syndrome in the Gambia: Comparison of the International Diabetes Federation and Adult Treatment Panel III Definitions

Background: The metabolic syndrome is a cluster of risk factors for cardiovascular diseases and diabetes mellitus. Objective: To compare and determine the level of agreement between International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (ATP) metabolic syndrome in the adult Gambian. Design: Cross-sectional study. Setting: Outpatient clinics of Edward Francis Small Teaching Hospital and Medical Research Council Laboratories in Banjul, The Gambia. Methods: Two hundred and eight consecutive patients with systemic hypertension on treatment and 108 non-hypertensive patients aged over 25years were enrolled. A questionnaire was filled and anthropometric measurements were taken. An oral glucose tolerance test (OGTT) was done as well as blood investigations including total cholesterol (TC), high-density lipoprotein cholesterol (HDL) and triglycerides (TG). Low-density lipoprotein cholesterol (LDL) was calculated using the Friedwald formula. Results: Three hundred and one participants with complete results were included in the analysis. The overall prevalence of IDF metabolic syndrome was 42% while that of ATP was 33%, with IDF identifying significantly more cases of metabolic syndrome than ATP (p < 0.0001). The kappa statistics for the agreement between the IDF and ATP metabolic syndrome for all the participants was substantial (k= 0.719, p<0.0001). 86.7% of participants were classified similarly as having metabolic syndrome or not by both criteria. Conclusion: The prevalence of metabolic syndrome was high by both the IDF and ATP criteria in Banjul and the level of agreement between the two criteria was substantial.