Objective: To assess the risk factor pattern of the metabolic syndrome and its association with insulin resistance and hyperuricaemia in a sub-Saharan African population with different levels of urbanisation.
Methods: Four hundred forty-eight black South African volunteers, men and women aged 15 years and older were investigated in a cross-sectional, comparative, population-based survey. Subjects were stratified into three groups representing different levels of urbanisation in rural and urban areas. The metabolic syndrome was defined according to IDF criteria. Factor analysis was used to examine the risk factor pattern of the metabolic syndrome.
Results: The prevalence of the metabolic syndrome was low and did not differ across the three groups. Factor analysis showed slight differences in the metabolic syndrome pattern between the groups. Hyperuricaemia-hypertriglyceridaemia was identified as distinct component in the rural and semiurban group whereas hyperinsulinaemia was loaded together with other risk factors. In the entire study population, five factors could be identified in the following sequence: obesity, hypertension, hyperuricaemia-hypertriglyceridaemia, hyperglycaemia and hyperinsulinaemia. Subjects with hyperuricaemia but not with insulin resistance exhibited an increased risk to develop the metabolic syndrome.
Conclusions: Hyperuricaemia was revealed as additional component of the metabolic syndrome in sub-Saharan Africans and should be given more attention in prevention settings.