Metabolic Syndrome in Indigenous Amerindian Women in Suriname; Less on Waist and More on Weight?

Abstract

Background: The indigenous Amerindian populations living in the southern interior part of Suriname have to date largely maintained their traditional hunter-gatherer life-style. In this study we compared the prevalence of metabolic syndrome (MeTS) and its component risk factors between indigenous Amerindian women of the interior of Suriname, with indigenous Amerindian women living in the coastal-rural areas who have a more urbanized lifestyle. We focused on women since the Suriname Health study showed that Indigenous women had the second highest MeTS prevalence nationwide. Methods: A subset of secondary data from the Suriname Health Study was used. The prevalence of cardiovascular risk factors and of MeTS and its component risk factors were compared between the two populations, using analyses of variance and chi-square tests. Results: Both groups had comparable MeTS prevalence’s of almost 40%. Elevated fasting blood glucose occurred twice more frequently in the coastal-rural compared to the interior women (51.2% vs. 24.7%). The prevalence of pre-diabetes was statistically significantly higher in the coastal-rural compared to the interior (43.1% vs. 17.3%), while diabetes mellitus and hypertension rates did not differ statistically significantly between the two groups (resp. 19.1% vs. 14.1% and 5.8% vs. 4.1%). Elevated triglycerides were more than twice more prevalent in the interior compared to the coastal-rural area (43.1% vs. 17.3%), possibly related to alcohol consumption. The obesity prevalence was around 50% in the coastal-rural women, almost three times higher than in the interior, while both groups had comparable prevalence’s of an increased waist circumference and waist/height ratio (around 80%). Lifestyle differed statistically significantly between the coastal-rural and interior women: coastal-rural women smoked more, had less vigorous daily activities, more frequently consumed meals from restaurants or fast food and more frequently used sugary soft drinks. Conclusion: Despite a comparable MeTS prevalence of almost 40%, behavioral and other CVD risk factors differed statistically significantly between women living in coastal-rural areas and those in the interior. Interior women had statistically significantly lower pre-diabetes and obesity rates. In both groups the majority of the women (around 80%) had an increased waist circumference, which could be common in Amerindian people, unrelated to cardiovascular risk and needs to be studied further. Keywords: Indigenous; Amerindian; Suriname; Medical Mission; MeTS; Obesity; Waist cirumference; Hypertriglyceridemia; Lifestyle List of Abbreviations: BMI: Body mass index; CVD: Cardiovascular disease; EFG: Elevated fasting glucose; HDL: High density lipoprotein; MeTS: Metabolic syndrome; WC: Waist circumference; WHO: World Health Organization