Diabetes mellitus hypertension and related factors in black subjects residing in Qwaqwa and Bloemfontein
| dc.contributor.advisor | Weich, D. J. V. | |
| dc.contributor.advisor | Joubert, G. | |
| dc.contributor.advisor | Steyn, K. | |
| dc.contributor.advisor | Steyn, A. F. | |
| dc.contributor.author | Mollentze, Willem Frederik | |
| dc.date.accessioned | 2017-06-20T06:51:43Z | |
| dc.date.available | 2017-06-20T06:51:43Z | |
| dc.date.issued | 2003 | |
| dc.description.abstract | English: BACKGROUND The black population of South Africa underwent rapid urbanisation during the last century. This process was accompanied by major changes in lifestyle including less physical activity, the moving away from traditional low-fat diets to diets high in saturated fat, and the acquiring of unhealthy habits such as the smoking of cigarettes. Previously rare chronic diseases of lifestyle such as diabetes mellitus, hypertension, obesity, dyslipidaemia and atherosclerotic cardiovascular disease started to emerge during this period. AIMS The primary aims of the study were to determine the prevalence of diabetes mellitus, hypertension, obesity, and dyslipidaemia, in a partly rural and an urban black community. The secondary objectives were to investigate the hypotheses that the metabolic syndrome existed in the black population and that hypertension was associated with hyperinsulinaemia in the study populations. STUDY DESIGN A cross-sectional study SETTING: The study was conducted in the semi-rural area of Qwaqwa and in Mangaung, the main black residential area of Bloemfontein. METHODS A representative sample of 853 subjects 25 years and older (279 males and 574 females) was selected from Qwaqwa, a partly rural community in the Free State, and a similar sample of 758 subjects (290 males and 468 females) from Mangaung, the black residential area of Bloemfontein, as the urban sample for comparison. After informed consent, the prevalence of the following conditions was determined according to standardised procedures: diabetes mellitus, impaired glucose tolerance, impaired fasting glucose, hypertension, dyslipidaemia, and overweight and obesity. In addition, anthropornetrlcal measurements including the measurement of selected skinfold thickness and body circumferences were measured. A 12- lead resting electrocardiograph was obtained from each subject and blood specimens were collected for the measurement of insulin, proinsulin and C-peptide. A trained nurse administered a questionnaire to each respondent in his or her own language to obtain demographic and biosocial information. RESULTS The response rates were 68% in Qwaqwa and 62% in Mangaung. The age-standardised prevalence rates for the chronic diseases that were studied, are provided in the Table 51. Table A1 will be attached on the full document. The prevalence rates of the risk factors that were studied did not differ significantly between the Qwaqwa and Mangaung samples. Although the metabolic syndrome was present in 31% of subjects in both samples, no electrocardiographic evidence of an increased prevalence of coronary heart disease was found in subjects with the metabolic syndrome. Hyperinsulinaemia and thus insulin resistance was not associated with hypertension in any of these two black populations with a high prevalence of obesity and hypertension. It is unlikely that a population with such a clustering of cardiovascular risk factors can much longer escape the emergence of coronary artery disease as an important public health problem. CONCLUSION The black populations of Qwaqwa and Mangaung are well advanced on the raad of urbanisation and the nutrition transition. Chronic diseases of lifestyle are as prevalent in these communities as elsewhere in the Western world. Coronary artery disease is usually the last of the typical Western diseases to emerge in a population in transition and it is unlikely that these black populations will escape this disease much longer. | en_ZA |
| dc.description.abstract | Afrikaans: AGTERGROND Die swart bevolking van Suid-Afrika het gedurende die vorige eeu 'n proses van vinnige verstedeliking ondergaan. Hierdie proses het gepaard gegaan met belangrike veranderinge in lewensstyl insluitende 'n afname in fisiese aktiwiteit, die wegbeweeg van 'n tradisionele dieet laag in vet na 'n dieet hoog in versadigde vette tesame met die aanvaarding van ongesonde gewoontes soos die rook van sigarette. Die chroniese siektes van lewensstyl soos diabetes mellitus, hipertensie, obesiteit, dislipiedemie en aterosklerotiese kardiovaskulêre siekte wat voorheen skaars was onder swart mense, het gedurende hierdie periode na vore getree. DOELWITTE Die primêre doelwitte van hierdie studie was om die voorkomssyfer van diabetes mellitus, hipertensie, obesiteit en dislipiedemie in 'n gedeeltelike landelik en in 'n stedelike swart bevolking te bepaal. Die sekondêre doelwitte was om die hipoteses te ondersoek dat die metaboliese sindroom wel voorkom in die swart bevolking en dat hipertensie geassosieer is met hiperinsulinemie in hierdie bevolkings. STUDIE ONTWERP 'n Deursneestudie. OMGEWING Die studie was uitgevoer in die deels landelike Qwaqwa en in Mangaung die hoof swart residensiële gebied van Bloemfontein. METODES 'n Verteenwoordigende steekproef van 853 vrywilligers 25 jaar en ouer (279 mans en 574 vroue) was lukraak geselekteer in Qwaqwa, 'n deels landelike gebied in die Vrystaat, en 'n soortgelyke steekproef van 758 vrywilligers (290 mans en 468 vroue) in Mangaung, die swart residensiële gebied van Bloemfontein, as die stedelike steekproef vir vergelykende doeleindes. Na ingeligte toestemming is die voorkomssyfer van die volgende toestande bepaal volgens gestandariseerde prosedures: diabetes mellitus, versteurde glukose toleransie, versteurde vastende glukose, hipertensie, dislipiedemie, oorgewig en obesiteit. Bykomstig is antropometriese metings insluitende die meting van geselekteerde velvoudiktes en liggaamsomtrekke gedoen. 'n 12-Afleiding rustende elektrokardiogram was by elke vrywilliger verkry en bloedmonsters was versamel vir die bepaling van serum insulien, pro-insulien en Cpeptiedvlakke. 'n Opgeleide verpleegkundige het 'n vraelys by elke vrywilliger in sv/haar eie taal afgeneem om demografiese en maatskaplike inligting te bekom. RESULTATE Die responssyfer was 68% in Qwaqwa en 62% in Mangaung. The ouderdoms aangepaste voorkomssyfer vir die chroniese siektes wat bestudeer is, word aangedui in Tabel Ul. Seen tabel U1 in dokuments. Die voorkomssyfer van die risikofaktore wat bestudeer is, het nie betekenisvol verskil tussen die Qwaqwa en Mangaung steekproewe nie. Alhoewel die metaboliese sindroom teenwoordig was in 31% van vrywilligers in beide steekproewe, kon geen elektrokardiografiese bewys van 'n verhoogde voorkomssyfer van koronêre vatsiekte in vrywilligers met die metaboliese sindroom aangetoon word nie. Hiperinsulinemie en dus insulienweerstandigheid was nie geassosieer met hipertensie in enige van die twee swart bevolkings met 'n hoë voorkomssyfer van obesiteit en hipertensie wat ondersoek is nie. Dit is onwaarskynlik dat 'n bevolking waarin daar so 'n mate van saambondeling van kardiovaskulêre risikofaktore teenwoordig is veel langer die ontstaan van koronêre vatsiekte as 'n belangrike openbare gesondheidsorgprobleem sal kan ontsnap. SAMEVATTING Die swart bevolking van Qwaqwa en Mangaung het reeds ver gevorder op die weg van verstedeliking en die nutrisionele oorgang. Chroniese siektes van lewensstyl is net so algemeen in hierdie gemeenskappe as elders in die Westerse wêreld. Koronêre vatsiekte is gewoonlik die laaste van die tipiese Westerse toestande wat ontstaan in 'n bevolking in oorgang en dit is onwaarskynlik dat hierdie swart bevolkings hierdie toestande veel langer sal kan ontsnap. | af |
| dc.description.sponsorship | Medical Research Council | en_ZA |
| dc.description.sponsorship | The Heart Foundation of Southern Africa | en_ZA |
| dc.description.sponsorship | Servier Laboratories South Africa (Ptv) Ltd | en_ZA |
| dc.description.sponsorship | University of the Free State, Department of Internal Medicine | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11660/6380 | |
| dc.language.iso | en | en_ZA |
| dc.publisher | University of the Free State | en_ZA |
| dc.rights.holder | University of the Free State | en_ZA |
| dc.subject | Diabetes mellitus, type 2 | en_ZA |
| dc.subject | Hypertension | en_ZA |
| dc.subject | Hyperinsulinaemia | en_ZA |
| dc.subject | Obesity | en_ZA |
| dc.subject | Dyslipidaemia | en_ZA |
| dc.subject | Metabolic syndrome | en_ZA |
| dc.subject | Blacks | en_ZA |
| dc.subject | Chronic diseases of lifestyle | en_ZA |
| dc.subject | Diabetes -- South Africa -- Bloemfontein | en_ZA |
| dc.subject | Diabetes -- South Africa -- Qwaqwa | en_ZA |
| dc.subject | Cardiovascular system -- Diseases | en_ZA |
| dc.subject | Hypertension | en_ZA |
| dc.subject | Thesis (D.Med.Sc. (Internal Medicine))--University of the Free State, 2003 | en_ZA |
| dc.title | Diabetes mellitus hypertension and related factors in black subjects residing in Qwaqwa and Bloemfontein | en_ZA |
| dc.type | Thesis | en_ZA |