Determinants of metabolic syndrome: a population survey at Bizerte military garrison in 2015-2017.

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Riadh Allani
Nadhem Amiri
Hassib Ammar
Sonia Dhaouadi
Imen Horrigue
Mohamed Taha Khoufi
Salem Bouomrani
Maher Béji

Abstract

Metabolic syndrome (MetS) is a worldwide major public health problem. In Tunisia, few studies have focused on MetS in general population and in military setting in particular.
Aim: To determine the prevalence of the MetS in a military population at Bizerte garrison (Tunisia) and to identify its associated factors.
Methods:
An analytical cross sectional study was conducted in Bizerte military garrison during the period 2015-2017. The study population was the active military persons who were presents during the time of the survey and assigned at the three main navy, air force and army units of Bizerte garrison. The adopted definition for the diagnosis of MetS was the International Diabetes Federation 2005 (IDF 2005). Multivariate analysis using a binary logistic regression model to identify independent factors to MetS (variable of interest) was performed. Data entry and analysis were performed using SPSS 20.0 Software.
Results:
During the study period, 2500 active military were enrolled among them 2418 men. The mean age was 36.6 ± 9.1 years [20.0 – 59.0]. The prevalence of MetS was 17.7%. MetS was significantly higher among participants aged 40 and above, (23.8% vs 13.1%), single (21.6% vs 13.7%), diabetic (38.5% vs 15.5%), and assigned in the air force (23.1% vs 14.6%) compared to the rest of the study population. The independent factors identified in multivariate analysis were age, armed forces’ affiliation and marital status.
Conclusion:
The prevalence of MetS in our military population was relatively high despite of the medical criteria imposed before incorporation. Population and targeted approach are needed to prevent this scourge and to protect from the complications.

Keywords:

Metabolic syndrome; prevalence; epidemiology ; military population ;Bizerte Résumé :

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References

  1. 1. Delarue J, Allain G, Guillerm S. Le syndrome métabolique. Nutrition Clinique et Métabolisme. 2006;20(2):114-7. 2. Ben Romdhane H, Khaldi R, Oueslati A, Skhiri Aouinallah H. La transition épidémiologique en Tunisie, ses déterminants et son impact sur les systèmes de santé. 2002;(41):7-28. 3. Essais O, Jabrane J, Bouguerra R, El Ati J, Ben Rayana C, Gaigi S, et al. Distribution et prévalence des dyslipidémies en Tunisie : Résultats de l'enquête nationale de nutrition. Tunis Med. 2009;87(8):505-10. 4. Allani R, Skhiri H, Bachrouch S, Mouaoui N, Ghyoula M, Ben Romdhane H. Les facteurs de risque cardio-vasculaire chez une population militaire : Le point de vue du médecin d'unité. Revue Tunisienne de la Santé Militaire. 2005;7:320-6. 5. Gotto AM, Whitney E, Stein EA, Shapiro DR, Clearfield M, Weis S, et al. Relation between baseline and on-treatment lipid parameters and first acute major coronary events in the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS). Circulation. 2000 Feb 8;101(5):477-84. 6. Bauduceau B, Baigts F, Bordier L, Burnat P, Ceppa F, Dumenil V, et al. Epidemiology of the metabolic syndrome in 2045 French military personnel (EPIMIL study). Diabetes Metab. 2005 Sep;31(4 Pt 1):353-9. 7. Ceppa F, Merens A, Burnat P, Mayaudon H, Bauduceau B. Military community: a privileged site for clinical research: Epidemiological Study of Metabolic Syndrome Risk Factors in the Military Environment. Mil Med. 2008 Oct;173(10):960-7. 8. Yadav D, Mahajan S, Subramanian SK, Bisen PS, Chung CH, Prasad G. Prevalence of Metabolic Syndrome in Type 2 Diabetes Mellitus Using NCEP-ATPIII, IDF and WHO Definition and Its Agreement in Gwalior Chambal Region of Central India. Glob J Health Sci [Internet]. 2013 Nov [cited 2021 May 30];5(6):142-55. Available from: https://www.ncbi.nlm. nih.gov/pmc/articles/PMC4776883/ 9. World Health Organization. Obesity [Internet]. [cited 2021 May 30]. Available from: https://www.who.int/westernpacific/health-topics/obesity 10. American Diabetes Association. Standards of Medical Care in Diabetes 2017. United States: ADA; 2017. 11. Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. The Lancet [Internet]. 2005 Apr 16 [cited 2021 May 30];365(9468):1415-28. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140- 6736(05)66378-7/abstract 12. Allal-Elasmi M, Haj Taieb S, Hsairi M, Zayani Y, Omar S, Sanhaji H, et al. The metabolic syndrome: Prevalence, main characteristics and association with socio-economic status in adults living in Great Tunis. Diabetes & Metabolism [Internet]. 2010 Jun [cited 2021 May 30];36(3):204-8. Available from: https://linkinghub.elsevier.com/retrieve/ pii/S1262363610000303 13. Ben Ali S, Belfki H, Aounallah-Skhiri H, Traissac P, Maire B, Delpeuch F, et al. Prevalence and determinants of the metabolic syndrome among Tunisian adults. Revue d Épidémiologie et de Santé Publique. 2012 Sep 1;60:S98-9. R. Allani & al. - Determinants of metabolic syndrome 668 14. Belfki H, Ben Ali S, Aounallah-Skhiri H, Traissac P, Bougatef S, Maire B, et al. Prevalence and determinants of the metabolic syndrome among Tunisian adults: results of the Transition and Health Impact in North Africa (TAHINA) project. Public Health Nutr. 2013 Apr;16(4):582-90. 15. Allani R, Bouomrani S, A M, R B, Saidi O, Asli S, et al. Prévalence du syndrome métabolique dans une cohorte de militaire du sud tunisien. Revue internationale des services de santé des forces armées: organe du Comité international de médecine et de pharmacie militaires = International review of the armed forces medical services: organ of the International Committee of Military Medicine and Pharmacy. 2014 Jan 1;87:5-11. 16. Tunisian national public health institute. results Tunisian health examination survey 2016. Tunis:INSP; 2019. 17. Al-Qahtani D, Imtiaz M. Prevalence of metabolic syndrome in Saudi adult soldiers. Saudi medical journal. 2005 Oct 1;26:1360-6. 18. Khazale NS, Haddad F. Prevalence and characteristics of metabolic syndrome in 111 Royal Jordanian Air Force pilots. Aviat Space Environ Med. 2007 Oct;78(10):968-72. 19. Bauduceau B, Baigts F, Bordier L, Burnat P, Ceppa F, Dumenil V, et al. Epidemiology of the metabolic syndrome in 2045 French military personnel (EPIMIL study). Diabetes Metab. 2005 Sep;31(4 Pt 1):353-9. 20. Crombie AP, Sanders LF, Sigrist LS, Walker LA, Young AJ. Prevalence of the Metabolic Syndrome in Active Duty Soldiers Enrolled in the Army Weight Control Program. Journal of the American Dietetic Association [Internet]. 2010 Sep 1 [cited 2021 May 30];110(9, Supplement):A28. Available from: https://www.sciencedirect.com/science/article/pii/S0002822310008059 21. Costa FF da, Montenegro VB, Lopes TJA, Costa EC. Combination of risk factors for metabolic syndrome in the military personnel of the Brazilian Navy. Arq Bras Cardiol. 2011 Dec;97(6):485-92. 22. Sharma S, Chandrashekar AM, Singh V. Metabolic Syndrome in Military Aircrew Using a Candidate Definition. Aerosp Med Hum Perform. 2016 Sep;87(9):790-4. 23. Kiani IG, Khan AN, Yasir S, Baluch UT. FREQUENCY OF METABOLIC SYNDROME IN TYPE-2 DIABETES MELLITUS. J Ayub Med Coll Abbottabad. 2016 Mar;28(1):59-62. 24. Balhara YPS, Kalra S, Bajaj S, Kuppili PP, Himanshu D, Atam V, et al. Uttar Pradesh Association of Physicians of India Position Statement: Tobacco Use and Metabolic Syndrome. J Assoc Physicians India. 2017 Dec;65(12):66-72. 25. Baygi F, Herttua K, Jensen OC, Djalalinia S, Mahdavi Ghorabi A, Asayesh H, et al. Global prevalence of cardiometabolic risk factors in the military population: a systematic review and meta-analysis. BMC Endocrine Disorders [Internet]. 2020 Jan 13 [cited 2021 May 30];20(1):8. Available from: https://doi.org/10.1186/s12902-020-0489-6 26. Rostami H, Tavakoli H, Rahimi M, Mohammadi M. Metabolic Syndrome Prevalence among Armed Forces Personnel (Military Personnel and Police Officers): A Systematic Review and Meta-Analysis. Military Medicine. 2019 Jun 27;184. 27. El Ati J, Zouari B, Delpeuch F, Hsairi M, Alouane L, Aounallah Skhiri H, et al. Stratégie Nationale de Prévention et de Lutte contre l'Obésité. Tunis: MSP; 2016. 28. Ministère de la Santé. Stratégie Nationale Multisectorielle de Prévention et Contrôle des Maladies Non Transmissibles(MNT) 2018-2025. Tunis:MSP; 2020.