Addo-Lartey, A.Abagre, T.A.University of Ghana, College of Health Sciences, School of Public Health2017-01-112017-10-142017-01-112017-10-142016-07http://197.255.68.203/handle/123456789/21255Thesis(MPH)-University of Ghana, 2016Background: Metabolic syndrome is a condition characterised by the clustering of cardiovascular disease risk factors such as obesity, hyperglycaemia, dyslipidaemia and high blood pressure. The condition frequently occurs among people with T2DM. The metabolic syndrome is associated with adverse health effects such as heart attack, stroke and other diseases involving the blood vessel. It is linked to more than two-fold increase risk of mortality compared with those without the syndrome. Despite knowledge about the health effects, there is limited dating on the prevalence, clustering and associated risk factors of the syndrome in Sub-Saharan Africa. More information is needed to guide health systems in the region to respond adequately to the increasing burden of these metabolic abnormalities. This was one of the rare studies that investigated the prevalence and associated risk factors of METs among people with T2DM using the harmonised definition and the continuous MSR score approach. The study also sought to identify the common components driving the METs burden in the study area. Methods: A cross-sectional study was conducted and METs was assessed using the harmonised definition and the continuous MSR score approaches. Data was collect between 1st and 27th June, 2016 at two hospitals in Dormaa and Berekum Municipalities respectively. Adults (aged 30-79 years) with type 2 diabetes mellitus who attended routine diabetes clinics were interviewed using semi-structured questionnaires. Medical records were used to confirm the type 2 diabetes mellitus status of participants. Weight, height, waist circumference, and BP were measured using standard procedures. Blood samples were also analysed for blood glucose, triglycerides, and HDL-cholesterol. Multiple logistic analyses model was used to explore the associated risk factors of METs measured as a binary outcome, whiles multiple linear regression was used to measure the risk factors of METs measured as a continuous risk score.Results: Data was collected from 430 participants. The mean age of participants was 58.8 years. The prevalence of the METs measured as a binary outcome was 68.6% (95% CI: 64.0 -72.8). The prevalence of the syndrome was higher in women (76.3%) than in men (58.0%). The odds of METs in women was 2.2 times (95% CI: 1.29 - 3.58, p=0.003) that of men. Duration of T2DM was predictive of the binary METs (OR 5.2, 95% CI: 2.90 - 9.31, p<0.001). Overweight was also observed to be a risk factor of the binary METs (OR 6.1, 95% CI: 3.70 - 10.07 p<0.001). The most pre-dominant components in this study were reduced HDL-cholesterol (70.2%), elevated waist circumference (60.9%) and raised SPB (49.8%). As a continuous outcome, the median MSR score was 0.89, 25th percentile (0.28) and 75th percentile (1.85). Compared with those aged 30-39 years, participants aged 60-69 years had surprisingly reduced MSR score (β= -0.65, 95% CI: -1.24- -0.07, p=0.029). Those aged 70-79 years also had reduced MSR score (β= -0.65, 95% CI: -1.24- -0.05, p=0.034). Duration of T2DM, overweight and education were the other independent risk factors of the MSR score in this study. Conclusion: This study demonstrated that METs is common among type 2 diabetes clinic attendees in the Dormaa and Berekum Municipalities. The analyses also support findings from previous studies in Ghana and abroad that observed sex differences in the prevalence of METs and its components. This study revealed that the risk factors of the MSR score might differ from those of the traditional binary METs outcome. Although epidemiologist might find the interpretation of the MSR scores useful, its application in clinical and public health decision making process might prove challenging when classifying who has METs. Nonetheless, the MSR score could be used to monitor the disease progression of an individual. Interventions aimed at promoting early identification of METs and adoption of healthy lifestyle practices should be strengthened among people with T2DM. Routine screening of METs among people with T2DM and at risk individual should be encouraged in health facilities across Ghana. Keywords: Type 2 diabetes, metabolic syndrome, risk factors, insulin resistance, and continuous metabolic syndrome risk scoreXiii, 102p: illenType 2 Diabetes MellitusMetabolic SyndromeBrong Ahafo RegionThesisUniversity of Ghana