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RÉSUMÉ
Introduction. L'obésité et le diabète contribuent au risque de maladie cardiovasculaire. Le but de cette étude était d’évaluer l'association entre l'obésité abdominale et générale et les facteurs de risque cardio-métaboliques, notamment la dyslipidémie et l'hypertension chez les patients diabétiques de type 2. Méthodes. Il s'agissait d'une étude rétrospective à visée analytique portant sur des patients atteints de diabète type 2. L'indice de masse corporelle (IMC) a été utilisé pour évaluer l'obésité générale des patients et le tour de taille a été mesuré pour définir l'obésité abdominale (sur la base de l'IDF 2009). Résultats. Au total, 141 patients diabétiques de type 2 ont été inclus dans l'étude, parmi lesquels 64 hommes (44,2%) et 77 femmes (55,8%). La prévalence de l'obésité générale et abdominale était respectivement de 25,5% et de 44,7%. Le taux d'obésité abdominale était plus élevé chez les femmes que chez les hommes (76,2% vs 23,8% ; p=0,00001). Les sujets ayant un IMC supérieur ou égal à 30 kg/m2 présentaient un risque plus élevé d'obésité abdominale que les patients dont l'IMC était inférieur à 30 kg/m2 (86,1% vs 30,5% ; p< 0,00001). Les patients souffrant d'obésité abdominale présentaient les moyennes de cholestérol total et de LDL cholestérol significativement plus élevées que les patients sans obésité abdominale respectivement p= 0,003 et p= 0,013. Conclusion. La prévalence de l’obésité était élevée dans la population diabétique de type 2 à Bouaké. Intérêt de dépister systématiquement les facteurs de risque chez les patients diabétique de type 2.
ABSTRACT
Introduction. Obesity and diabetes contribute to the risk of cardiovascular disease. The aim of this study was to assess the association between abdominal and general obesity and cardio-metabolic risk factors, in particular dyslipidaemia and hypertension in patients with type 2 diabetes. Material and methods. This was a retrospective, analytical study of patients with type 2 diabetes. Body mass index (BMI) was used to assess patients' general obesity and waist circumference was measured to define abdominal obesity (based on IDF 2009). Results. A total of 141 patients with type 2 diabetes were included in the study, including 64 men (44.2%) and 77 women (55.8%). The prevalence of general and abdominal obesity was 25.5% and 44.7% respectively. The rate of abdominal obesity was higher in women than in men (76.2% versus 23.8%; p=0.00001). Patients with abdominal obesity had significantly higher mean levels of total cholesterol and LDL cholesterol than patients without abdominal obesity, respectively p= 0.003 and p= 0.013. Conclusion. The prevalence of obesity was high in the type 2 diabetic population in Bouaké. It is important to systematically screen type 2 diabetic patients for risk factors.
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References
- Nguyen T, Lau DCW. The obesity epidemic and its impact on hypertension. Can J Cardiol 2012;28:326–33
- Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001;414:782–7
- Carr DB, Utzschneider KM, Hull RL, Kodama K, Retzlaff BM, Brunzell JD et al. Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. Diabetes 2004;53:2087–94
- Anari R, Amani R, Latifi SM, Veissi M, Shahbazian H. Association of obesity with hypertension and dyslipidemia in type 2 diabetes mellitus subjects. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2017;11:37–41
- American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2013;36 Suppl 1:S67-74
- Hanefeld M, Koehler C, Gallo S, Benke I, Ott P. Impact of the individual components of the metabolic syndrome and their different combinations on the prevalence of atherosclerotic vascular disease in type 2 diabetes: the Diabetes in Germany (DIG) study. Cardiovasc Diabetol 2007;6:13-20
- Song SH, Hardisty CA. Type 2 diabetes mellitus: a high-risk condition for cardiovascular disease irrespective of the different degrees of obesity. QJM 2008;101:875–9
- Colosia A, Khan S, Palencia R. Prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in observational studies: a systematic literature review. DMSO 2013;6:327-38
- Colditz GA, Willett WC, Rotnitzky A, Manson JE. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med 1995;122:481–6
- Iribarren C, Sharp DS, Burchfiel CM, Petrovitch H. Association of weight loss and weight fluctuation with mortality among Japanese American men. N Engl J Med 1995;333:686–92
- Lemos-Santos MGF, Valente JG, Gonçalves-Silva RMV, Sichieri R. Waist circumference and waist-to-hip ratio as predictors of serum concentration of lipids in Brazilian men. Nutrition 2004;20:857–62
- Hue A, Ma MS, Dago K, Yao A, Abodo J, Danho J et al. Obésité Abdominale et Complications du Diabète de Type 2 chez l’Africain Noir au Centre Hospitalier Universitaire de Yopougon, Abidjan. Health Sci Dis 2018;19(4):7-9
- Arersa KK, Wondimnew T, Welde M, Husen TM. Prevalence and Determinants of Hyperuricemia in Type 2 Diabetes Mellitus Patients Attending Jimma Medical Center, Southwestern Ethiopia, 2019. Diabetes Metab Syndr Obes 2020;13:2059–67
- Shahwan MJ, Jairoun AA, Farajallah A, Shanabli S. Prevalence of dyslipidemia and factors affecting lipid profile in patients with type 2 diabetes. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2019;13:2387–92
- Buse JB, Ginsberg HN, Bakris GL, Clark NG, Costa F, Eckel R et al. Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation 2007;115:114–26
- Satoh H, Kishi R, Tsutsui H. Body mass index can similarly predict the presence of multiple cardiovascular risk factors in middle-aged Japanese subjects as waist circumference. Intern Med 2010;49:977–82
- Marjani A. Prevalence of obesity among type 2 diabetes mellitus in Gorgan (South East of Caspian Sea), Iran. | Journal of Chinese Clinical Medicine | EBSCOhost 2011;6:85-9
- Dionadji M, Choua O, Voussia L, Abas O, Saleh A. Prévalence de l’obésité chez les professionnels de la santé de l’Hôpital Général de Référence Nationale à Ndjamena. Health Sci Dis 2016;17(1):1-3
- Mugharbel KM, Al-Mansouri MA. Prevalence of obesity among type 2 diabetic patients in al-khobar primary health care centers. Journal of Family and Community Medicine 2003;10:49-53
- Kone F, Danho J, N’guessan YAA, Acho JK, Toure KH, Kone S et al. Prévalence de la dyslipidémie chez les patients atteints de diabète de type 2 à Bouaké, Côte d’Ivoire. Rev Afr Méd Interne 2023;10:31–7
- Ridderstråle M, Gudbjörnsdottir S, Eliasson B, Nilsson PM, Cederholm J. Steering Committee of the Swedish National Diabetes Register (NDR). Obesity and cardiovascular risk factors in type 2 diabetes: results from the Swedish National Diabetes Register. J Intern Med 2006;259:314–22
- Steinmetz A, Fenselau S, Schrezenmeir J. Treatment of dyslipoproteinemia in the metabolic syndrome. Exp Clin Endocrinol Diabetes 2001;109:S548-59
- Winter Y, Rohrmann S, Linseisen J, Lanczik O, Ringleb PA, Hebebrand J, et al. Contribution of obesity and abdominal fat mass to risk of stroke and transient ischemic attacks. Stroke 2008;39:3145–51
- Berg AH, Scherer PE. Adipose tissue, inflammation, and cardiovascular disease. Circ Res 2005;96:939–49
- Daousi C, Casson IF, Gill GV, MacFarlane IA, Wilding JPH, Pinkney JH. Prevalence of obesity in type 2 diabetes in secondary care: association with cardiovascular risk factors. Postgrad Med J 2006;82:280–4
References
Nguyen T, Lau DCW. The obesity epidemic and its impact on hypertension. Can J Cardiol 2012;28:326–33
Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001;414:782–7
Carr DB, Utzschneider KM, Hull RL, Kodama K, Retzlaff BM, Brunzell JD et al. Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. Diabetes 2004;53:2087–94
Anari R, Amani R, Latifi SM, Veissi M, Shahbazian H. Association of obesity with hypertension and dyslipidemia in type 2 diabetes mellitus subjects. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2017;11:37–41
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2013;36 Suppl 1:S67-74
Hanefeld M, Koehler C, Gallo S, Benke I, Ott P. Impact of the individual components of the metabolic syndrome and their different combinations on the prevalence of atherosclerotic vascular disease in type 2 diabetes: the Diabetes in Germany (DIG) study. Cardiovasc Diabetol 2007;6:13-20
Song SH, Hardisty CA. Type 2 diabetes mellitus: a high-risk condition for cardiovascular disease irrespective of the different degrees of obesity. QJM 2008;101:875–9
Colosia A, Khan S, Palencia R. Prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in observational studies: a systematic literature review. DMSO 2013;6:327-38
Colditz GA, Willett WC, Rotnitzky A, Manson JE. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med 1995;122:481–6
Iribarren C, Sharp DS, Burchfiel CM, Petrovitch H. Association of weight loss and weight fluctuation with mortality among Japanese American men. N Engl J Med 1995;333:686–92
Lemos-Santos MGF, Valente JG, Gonçalves-Silva RMV, Sichieri R. Waist circumference and waist-to-hip ratio as predictors of serum concentration of lipids in Brazilian men. Nutrition 2004;20:857–62
Hue A, Ma MS, Dago K, Yao A, Abodo J, Danho J et al. Obésité Abdominale et Complications du Diabète de Type 2 chez l’Africain Noir au Centre Hospitalier Universitaire de Yopougon, Abidjan. Health Sci Dis 2018;19(4):7-9
Arersa KK, Wondimnew T, Welde M, Husen TM. Prevalence and Determinants of Hyperuricemia in Type 2 Diabetes Mellitus Patients Attending Jimma Medical Center, Southwestern Ethiopia, 2019. Diabetes Metab Syndr Obes 2020;13:2059–67
Shahwan MJ, Jairoun AA, Farajallah A, Shanabli S. Prevalence of dyslipidemia and factors affecting lipid profile in patients with type 2 diabetes. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2019;13:2387–92
Buse JB, Ginsberg HN, Bakris GL, Clark NG, Costa F, Eckel R et al. Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation 2007;115:114–26
Satoh H, Kishi R, Tsutsui H. Body mass index can similarly predict the presence of multiple cardiovascular risk factors in middle-aged Japanese subjects as waist circumference. Intern Med 2010;49:977–82
Marjani A. Prevalence of obesity among type 2 diabetes mellitus in Gorgan (South East of Caspian Sea), Iran. | Journal of Chinese Clinical Medicine | EBSCOhost 2011;6:85-9
Dionadji M, Choua O, Voussia L, Abas O, Saleh A. Prévalence de l’obésité chez les professionnels de la santé de l’Hôpital Général de Référence Nationale à Ndjamena. Health Sci Dis 2016;17(1):1-3
Mugharbel KM, Al-Mansouri MA. Prevalence of obesity among type 2 diabetic patients in al-khobar primary health care centers. Journal of Family and Community Medicine 2003;10:49-53
Kone F, Danho J, N’guessan YAA, Acho JK, Toure KH, Kone S et al. Prévalence de la dyslipidémie chez les patients atteints de diabète de type 2 à Bouaké, Côte d’Ivoire. Rev Afr Méd Interne 2023;10:31–7
Ridderstråle M, Gudbjörnsdottir S, Eliasson B, Nilsson PM, Cederholm J. Steering Committee of the Swedish National Diabetes Register (NDR). Obesity and cardiovascular risk factors in type 2 diabetes: results from the Swedish National Diabetes Register. J Intern Med 2006;259:314–22
Steinmetz A, Fenselau S, Schrezenmeir J. Treatment of dyslipoproteinemia in the metabolic syndrome. Exp Clin Endocrinol Diabetes 2001;109:S548-59
Winter Y, Rohrmann S, Linseisen J, Lanczik O, Ringleb PA, Hebebrand J, et al. Contribution of obesity and abdominal fat mass to risk of stroke and transient ischemic attacks. Stroke 2008;39:3145–51
Berg AH, Scherer PE. Adipose tissue, inflammation, and cardiovascular disease. Circ Res 2005;96:939–49
Daousi C, Casson IF, Gill GV, MacFarlane IA, Wilding JPH, Pinkney JH. Prevalence of obesity in type 2 diabetes in secondary care: association with cardiovascular risk factors. Postgrad Med J 2006;82:280–4