Researchers at Weill Cornell Medicine-Qatar (WCM-Q) have adapted an international measure used to assess the prevalence of metabolic syndrome – a serious condition linked to diabetes, heart disease and stroke – to the Qatari population.
Metabolic syndrome is diagnosed by the presence of three or more of five risk factors: abdominal obesity, raised blood pressure, raised fasting blood glucose, raised levels of triglycerides (fatty acids present in the blood), and reduced levels of high-density lipoproteins – so-called ‘good’ cholesterol.
By analysing large amounts of data collected by earlier health surveys conducted in Qatar, the WCM-Q team found that waist circumference was the best predictor of the presence of the other determinants of metabolic syndrome. However, the research team, led by WCM-Q’s Dr Ravinder Mamtani, decided to go further and adapt the international waist measurement criteria set out by the International Diabetes Federation (IDF) to create a population-specific set of parameters for Qatari nationals.
Dr Mamtani, Senior Associate Dean for Population Health and Capacity Building at WCM-Q, said:
Because of a lack of data in the Middle East, the IDF actually recommends using European waist measurement cut-off points for assessing metabolic syndrome in Middle Eastern populations.’
Sheikh Dr Mohamed H Al Thani, Director of Public Health, Ministry of Public Health, and a principal member of the research team said:
We realised that there is actually some very good data available in Qatar so we decided to look at it closely and devise a set of waist measurement parameters for assessing metabolic syndrome that is tailored specifically to the Qatari population.’
‘This has given us a better understanding of the prevalence of metabolic syndrome among Qataris and we believe it will help health professionals target interventions more accurately to address the growing problem of obesity and related conditions, which is a very pressing concern throughout the region.’
The researchers used sophisticated statistical analysis methods to analyse data on 2,496 Qatari citizens collected in the Qatar National STEPwise Survey in 2012 by the Supreme Council of Health (now the Ministry of Public Health). The results of the analysis allowed the researchers to determine that a waist circumference for Qatari men of 102cm or more, and of 94cm or more for Qatari women, was the best predictor of the presence of the other determinants of metabolic syndrome. That compares to the European cut-off points of 94 cm and 80 cm respectively that are currently used by the IDF for assessing Middle Eastern populations.
Using the Qatari-specific cut-off points, the WCM-Q team found that approximately 28 percent of Qataris satisfy the criteria for metabolic syndrome – a considerably lower level than the estimate of 37 percent calculated using the European cut-off points recommended by the IDF.
Dr Sohaila Cheema, Assistant Professor of Healthcare Policy and Research at WCM-Q, said:
This study is important because using cut-off points that are not appropriate to the ethnic group being studied risks skewing the results and giving an inaccurate picture of the true prevalence of metabolic syndrome. Each ethnic group has unique characteristics, so we feel that if you have good data for a group it is very beneficial to use it to determine more suitable cut-off points, which is what we have managed to do with this project.’
The WCM-Q team worked in partnership with researchers from Qatar’s Department of Public Health, New York Medical College, and the European Institute of Oncology in Milan, Italy on the study. The paper is titled ‘Prevalence and determinants of metabolic syndrome in Qatar: results from a National Health Survey’ and has been published in the prestigious medical journal BMJ Open. The total sample size of 2,496 individuals aged 18-64 comprised 1,053 men and 1,443 women.
The analysis of the data also revealed that people with lower levels of educational attainment were more likely to have metabolic syndrome, as were people who reported lower levels of physical activity.
Dr Mamtani added:
We are confident that these population-specific cut-off points will allow for better identification of metabolic syndrome at the individual level in Qatar, but also provide guidance to other countries in the region.’
Other authors of the paper include Dr Al Anoud Mohammed Al Thani, Manager of Non Communicable Diseases, Dr Walaa F Al Chetachi, Shamseldin A H Khalifa, Dr Ahmad OH Bakri of the Department of Public Health, Ministry of Public Health, Dr Badria A Al Malki from Primary Health Care Corporation, Dr Javaid Sheikh, Dean of WCM-Q, Dr Albert Lowenfels of the Department of Surgery and the Department of Family Medicine at New York Medical College, Valhalla, New York and Patrick Maisonneuve, of the European Institute of Oncology, Milan, Italy.