The association between alcohol consumption and the metabolic syndrome and its component diseases in a rural Ghanaian population

Abstract

Background: Metabolic syndrome (MS) is a combination of risk factors that increase cardiovascular disease (CVD) risk. Current evidence suggests an association between alcohol intake and MS. Despite the high levels of alcohol consumption in Navrongo, data on its association with MS is non-existent. The aim of this study was to determine the prevalence of MS and its components and determine the association of alcohol consumption patterns with MS and its component diseases among 40-60 year olds in rural Northern Ghana. Methods: This was a cross-sectional study leveraged on secondary data from the Navrongo, Ghana site of the African-Wits-INDEPTH Partnership for Genomic Studies (AWI–Gen study). The CAGE questionnaire was used to assess harmful alcohol consumption and MS was defined based on the 2009 International Diabetes Federation/ National Heart, Lung, and Blood Institute/ American Heart Association (IDF/AHA/NHLBI) criteria. Multivariable regression analyses were used to determine the association between alcohol intake and MS. Results: We present results for 1875 participants of which 53.9% were women. The mean age was 51.1±5.78 years. The overall MS prevalence was 7.63%, with a notable female predominance (females: 12.5%; males: 1.97% [p<0.001]). The most prevalent MS components were low HDL (55.2%), elevated blood pressure (34.9%) and high waist circumference (17.7%). Majority (84.9%) of the participants had a history of alcohol intake. Current drinking was more prevalent among men than women (77.9% vs. 54.7%; p<0.001). Among men, the adjusted odds ratios [95% CIs] of MS were 0.03 [0.002-3.26]) for previous drinkers, 1.69 [0.18-16.0] for current non-problematic drinkers and 0.46 [0.04-5.19] for current problematic drinkers. For women, the adjusted odds ratios [95% CIs] of MS were 0.82 [0.42-1.57]) for previous drinkers, 0.66 [0.37-1.18] for current non-problematic drinkers and 0.63 [0.30-1.31] for current problematic drinkers with non-drinkers as the reference group. Alcohol consumption was significantly associated with hyperglycaemia among women (p=0.025) and low HDL among both men (p<0.001) and women (p=0.031). Conclusion: Despite the overall prevalence of MS being relatively low, the much higher prevalence among women is alarming. Alcohol intake did not influence the occurrence of MS in this population. However significant associations with hyperglycaemia and low HDL levels were noted, highlighting the need for further investigation. The high prevalence of alcohol intake in this population suggests that measures to control alcohol consumption are required. Thus, alcohol intake assessment at the primary care level could be introduced