Burden and predictors of metabolic syndrome in adolescents and young adults in Blantyre district, Malawi.

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Metabolic syndrome (MetS) is a major public health concern as it is on the rise in developing countries. However, there is limited regional and national data specifically in adolescents to help drive interventions against MetS. To describe the burden and predictors of MetS in adolescents and young adults in Blantyre district. This was a cross-sectional study that used secondary data. MetS related risk factors from socio-demographic characteristics, anthropometric indices and body composition by deuterium dilution technique (DDT) were assessed. MetS was diagnosed using 1) the international diabetes federation (IDF) criteria by the presence of three or more of the following components: raised blood pressure (BP), raised fasting blood glucose (FBG), reduced high density lipoprotein (HDL), raised triglycerides and larger waist circumference (WC), 2) Metabolic syndrome severity score (MSSS) using these inputs: age, gender, race, weight, height, FBG, BP and HDL on an online calculator. Multivariate logistic regressions were applied to identify MetS -associated risk factors. The study enrolled 371 adolescents and young adults aged 10-28 years The most prevalent MetS component was raised FBG at 31.3 % and reduced HDL at 30 % while the least common component was raised blood pressure BP at 3%. The overall prevalence of MetS was 3.1% by MSSS and 2.5% by IDF criteria and all participants had mild MetS. There was no difference in MetS prevalence by all socio-demographic characteristics and anthropometric indices including history of treatment for acute malnutrition except for waist to height ratio (WHtR). High WHtR and excess fat % were associated with MetS in unadjusted regression analysis with Odds Ratio (OR) 95% Confidence interval (CI)) of 5.18 (0.33,0.91) and 8.87 (1.91,41.08) respectively. After adjusting for sex, age, maternal occupation, WHtR and WHR, participants with excess fat % had 6 times more risk of MetS compared to those with no excess fat%, OR (CI) of 5.88, (1.37,35.4). Conclusions: MetS was relatively rare in this population at 3% prevalence. Abnormal body composition, especially presence of excess fat% increases the odds of presence of MetS.