Background: Waist circumference threshold values used in sub-Saharan Africa correspond to those of European\npopulations and are therefore inappropriate. Thus, they may over predict insulin resistance, especially in hypertensive\nAfricans, in whom there is often no association between blood pressure and insulin resistance. Using bioelectrical\nimpedance measurement in sub-Saharan Africa could possibly be advantageous to overcome the shortcomings of waist\ncircumference measurement. The aim of this study was to evaluate the contribution of body composition estimation by\nbioelectrical impedance to predict cardiometabolic risk in Congolese hypertensive subjects.\nMethods: Cardiovascular profiling and body composition analysis by bioelectrical impedance was measured in 400\npatients (men = 40%; age = 51.1 Ã?± 12.6 years). Patients were diagnosed with a metabolic syndrome (MS) according to the\nIDF Criteria with and without the ââ?¬Å?blood pressureââ?¬Â criterion to remove any confounding autocorrelation bias, a visceral\nfat-MS (with and without the ââ?¬Å?blood pressureââ?¬Â criterion) being defined by the presence of ? 2 criteria with the precondition\nof excess visceral fat defined by a bio impedance measurement score >10/30. Total cardiovascular risk was assessed using\nthe criteria of Framingham-2008.\nResults: The frequencies of enlarged waist circumference (71.9% vs 68.9%, p = 0.52) and IDF-MS without blood pressure\ncriterion (24.9% vs 21.9%, p = 0.48) were similar among hypertensive vs. non hypertensive however excess visceral fat\n(57.6% vs 33.8%, p <0.0001) as well as visceral fat-MS without blood pressure criterion (18.9% vs 11.3%, p = 0.04) were more\nprevalent among hypertensive. Finally, total cardiovascular risk as well as arterial hypertension risk were associated with\nvisceral fat, but not with waist circumference (p > 0.05).\nConclusions: Pending the determination of thresholds values for pathological waist circumference adapted to sub-Saharan\npopulations, using bioelectrical impedance measurement may contribute to better characterize the cardiometabolic risk\nand the insulin resistant phenotype of hypertensive sub-Saharan Africans.
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