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Vol. 7, No. 2, 2025, pp. 87-95 ISSN 2656-6052 (online) | 2656-1107 (print) 
      http://journal2.uad.ac.id/index.php/eshr/index                                                   eshr@ikm.uad.ac.id 

 

 

      10.26555/eshr.v7i2.12641  

 
 

87 

 
 

  

 
Research Article  
 
Prevalence of Metabolic Syndrome Among Patients with 
Type 2 Diabetes at the Bon Samaritain University Hospital 
Complex in N’Djamena, Chad 
 
Suitombaye Noubaramadji Yamti*1,2, Abel Dafogo Djibagaou1,2,6, Koutaya 
Dezoumbe1,2,6, Amine Akouya1,2, Zita Aleyo Nodjikouambaye1, Andrillene Laure 
Deutou Wondeu1,2, Brahim Boy Otchom4, Sabrina Atturo1, Giulia Cappelli1,5, 
Vittorio Colizzi1,6 
 
1 Laboratoire des Grandes Épidémies Tropicales, Bon Samaritain University Hospital 

Complex, N’Djamena, Chad 
2 Faculty of Sciences and Technologies of the Evangelical University of Cameroon, Mbouo-

Bandjoun, Cameroon 
3 University of Tor Vergata, Rome, Italy 
4 Toumaï University, N’Djamena, Chad 
5 Laboratory of Immunology, National Research Council, Rome, Italy 
6 Faculty of Medicine, Bon Samaritain University Hospital Complex, N’Djamena, Chad 
 
*Correspondence: noubaramadji.yamti@gmail.com.  
Received 20 January 2025; Accepted 02 September 2025; Published 02 September 2025 
 
ABSTRACT 

Introduction: The Metabolic Syndrome (MS) is characterized by the presence of at least three 
of the following five factors: abdominal obesity, hypertriglyceridemia, low HDL-cholesterol, 
glucose intolerance or type 2 diabetes, hypertension. It is relatively common with a prevalence 
that increases with age and predisposes to the occurrence of cardiovascular complications, 
hence the motivation of this study, the aim of which was to determine its prevalence in a Chadian 
population. 
Method: We conducted a prospective study involving 115 subjects aged 20 to 80 received at 
the Biochemistry laboratory as part of a monthly visit. The anthropometric and clinical data were 
recorded, and the biochemical parameters were analyzed on the PENTRA C400 automaton. 
The MS was defined according to the criteria of the NCEP-ATP III (2001). All of these data were 
analyzed using Excel 2013 and IBM SPSS software. 
Results: in our study the prevalence of MS is 72.2% of cases with a female predominance of 
86.15% and it increases with age. The most frequent components of the metabolic syndrome 
were abdominal obesity (71%), arterial hypertension (45%), hypo HDL-cholesterol. 
Conclusion: our results show a high prevalence of MS and its main components which are 
abdominal obesity, arterial hypertension, hypo HDL-cholesterol, explaining in parallel a high 
level of cardiovascular risk. Management should be multidisciplinary to optimize the risk of 
chronic complications. 

Keywords: Metabolic Syndrome; Abdominal Obesity; Hypertension; Chad 

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Vol. 7, No. 2, 2025, pp. 87-95 88   10.26555/eshr.v7i2.12641 

  

INTRODUCTION 
Metabolic Syndrome (MS) is characterized by the presence of several metabolic abnormalities 
including at least three of the five associated factors in the same individual (abdominal obesity, 
hypertriglyceridemia, low HDL-cholesterol, glucose intolerance or type 2 diabetes, 
hypertension). It is a major risk factor for cardiovascular disease and type 2 diabetes (T2DM). 
Added to this is the risk of chronic pro-inflammatory, pro-thrombotic conditions and non-
alcoholic fatty liver disease.1 First called syndrome X, then insulin resistance syndrome, MS 
has had several definitions during its evolution.1 In the world, its prevalence varies according 
to the country but also according to the definitions used. In Europe, the prevalence is around 
20%, whereas in the United States the figures are higher.2 In Africa, there are few data on MS 
apart from a few countries such as Tunisia, Ivory Coast and Burkina where prevalence of 
about 7% have been reported.3 several studies carried out both in the general diabetic 
population and among target groups have demonstrated the increasing frequency of metabolic 
syndrome and its consistent association with diabetes4 and cardiovascular disease5. 
Worldwide, its prevalence varies not only from country to country, but also according to the 
definitions used. 

Diagnostic criteria for MS have been proposed by many groups, including the World Health 
Organization (WHO, 1998), the European Group for the Study of Insulin Resistance (EGIR, 
1999),6 the American Association of Clinical Endocrinologists (AACE, 2003),7 the National 
Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III, 2001)8, the National 
Cholesterol Education Program Revised Adult Treatment Panel III (NCEP-ATP III Revised, 
2005)9, the International Diabetes Federation (IDF, 2005),10 and a consensus between the 
AHA/NHLBI and IDF (Joint Interim Statement, 2009).11 There is agreement about the various 
components of MS, but there are differences in the details of the criteria used to describe them 
and their cut-off values.12 Several studies conducted both in the general diabetic population 
and among target groups have demonstrated the increasing prevalence of metabolic 
syndrome and its consistent association with diabetes13,14 and cardiovascular diseases. 
Globally, its prevalence varies not only between countries but also according to the definitions 
used.15  

None of these definitions have been established on a sample of African, but mainly West- ern, 
individuals, making it difficult to choose one of the definitions for studies done in Africa.16 This 
sometimes justifies the use of several definitions. Previously thought to be uncommon in 
Africa, numerous studies have revealed higher prevalence in various Sub-Saharan African 
countries, most notably in Nigeria (23%)17 and Ghana (41.8%);18 and in North African countries 
with prevalence of 39.6% and 48.5% observed in Tunisia and Morocco respectively.19,20 
Because of the rapid rise in MS, non-communicable diseases (NCDs) such. 

Due to the dramatic increase in urbanization, smoking, severe stress-related problems of 
poverty, nutrition transition, reduced physical activity, and over nutrition increasing on top of 
the already high prevalence of undernutrition, sub-Saharan Africa is facing a rapid escalation 
of MS and noncommunicable chronic diseases and associated mortality21 and particularly 
Chad, we have set ourselves the objective to determine the prevalence of the metabolic 
syndrome and its components in type 2 diabetics in a Chadian population. 

 

 

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Vol. 7, No. 2, 2025, pp. 87-95 89   10.26555/eshr.v7i2.12641 

  

METHOD 
Type, and study population 

This was a descriptive and analytical cross-sectional study involving 115 subjects received for 
monthly diabetic follow-up in the laboratory of the "Le Bon Samaritain" University Hospital 
Complex (CHU-BS) in N'Djamena, Chad. Included in the study were all subjects who had 
undergone a blood test (glycaemia) provided for by this monthly medical check-up and who 
had consented to participate in the study. A questionnaire prepared in advance was made 
available to them in order to have information on their socio-demographic data. Then a clinical 
examination including anthropometric measurements was carried out and at the end a 
biochemical examination was carried out. Clinical and anthropometric data were collected on 
survey forms designed for this purpose. The parameters evaluated were age, sex, blood 
pressure and waist circumference.  

For the biochemical analysis, blood samples were taken by venipuncture at the bend of the 
elbow in subjects who had fasted for at least 12 hours. For each patient, blood was collected 
in a tube containing citrate. After centrifugation, the serum was used immediately for the 
determination of biochemical parameters including glycaemia, triglycerides and HDL 
cholesterol. These assays were carried out using suitable enzymatic methods on the PENTRA 
C400 automaton. 

All procedures were conducted in accordance with the Declaration of Helsinki. Written 
informed consent was obtained from each participant prior to inclusion. The study protocol 
was submitted to and approved by the management of the Bon Samaritain University Hospital 
(CHU-BS) before the start of the activities. 

The metabolic syndrome has been defined according to the (National Cholesterol Education 
Program); Adult Treatment Panel III (NCEP-ATP III) criteria [10]: abdominal obesity (waist 
circumference > 102 cm (men); > 88 cm (women), arterial hypertension (AP ≥ 130/85 mm Hg), 
hypertriglycideremia (≥ 1.50 g/l), decreased HDL cholesterol (< 0.40 g/l (men); < 0.50 g/l 
(women) and hyperglycemia (≥ 1.10 g/l /l); subjects with at least three of these criteria were 
considered to have a metabolic syndrome. 

Statistical analyzes 

All data was entered and coded in Windows Excel 2013 and then analyzed using IBM SPSS 
Statistics 21.0. The comparison of the quantitative variables was made using the Student's T 
test, the comparison of the percentages required the chi-square test. The 95% confidence 
interval (95% CI) and A p value <0.05 was considered significant. 

 

RESULTS 
Our study included 115 subjects including 50 men and 65 women. It follows from Table 1 
(Appendix) presenting the distribution of participants according to age groups and level of 
education that most of the participants were between 50-60 years (33.9%) and 60-70 years 
(33.9%). 

 

 

 

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Table 1. Distribution of participants by age group and level of education 
 

 

 

 

 

 

 

 

 

 

Furthermore, 40% of the participants have a higher level of education, 23.5% have a 
secondary level, 6.1% have a primary level of education, and finally 30.4% are unschooled. A 
female predominance was observed (Figure 1). 

 

Figure 1. Breakdown of Study Participants by Gender 
 

The breakdown of participants by sex shows a predominance of women, with 65 women 
(56.5%) and 50 men (43.5%). This predominance is still feminine in terms of the presence or 
absence of SM in this population (Table 2). 

 
Table 2. Distribution of participants by gender and by presence or absence of SM. 

 
Sex N 

Attendees 
Presence of 

SM 
% Presence of 

SM 
Absence of 

SM 
% Absence of 

SM 
Female 65 (56.5%) 59 51.3 6 5.2 
Male 50 (43.5%) 24 20.9 26 22.6 
Total 115 (100%) 83 72.2 32 27.8 

 

The prevalence of MS in our study population is 72.2%, among the elements that compose it, 
hyperglycemia and hypo HDL-cholesterol were the two criteria mainly present with 88% for 

Settings N Percentage (%) 
Age range 30-40 9 7.8 

40-50 21 18.3 

50-60 39 33.9 

60-70 39 33.9 

70-80 7 6.1 

Level of education Superior 46 40.0 

Secondary 27 23.5 

Primary 7 6.1 

No schooling 35 30.4 

Total 115             100 

Female Male 

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hyperglycemia, 81% for hypo HDL-cholesterol followed by abdominal obesity (71%), and 
arterial hypertension (45%), in the end hypertriglyceridemia was noted in (25) % (Figure 2).  

 
Metabolic Syndrome, HTA= arterial hypertension, TG= triglycerides, Gly = blood sugar, 

HDL-c= high density lipoprotein cholesterol 

Figure 2. Prevalence of Metabolic Syndrome and its components in the study population 

Of the 83 patients identified with metabolic syndrome (MS), 39 (34%) met 3 diagnostic criteria, 
while 27 (23%) fulfilled 4 criteria and 17 (15%) met all 5 criteria. In addition, 17% of the study 
population presented 2 criteria, indicating a group at high risk of progression towards full MS 
(Table 3). 

Table 3. Clinico-biochemical profile of participants according to the number of metabolic 
syndrome criteria 

Settings N attendees Percentage 

1 criteria 13 11% 

2 criteria 19 17% 

3 criteria 39 34% 

4 criteria 27 23% 

5 criteria 17 15% 

Total 115 100% 

 

41.7% of the study population practices at least one physical activity against 58.3% of those 
who do not practice any physical activity (Table 4). 

DISCUSSION  

The prevalence of MS varies greatly depending on the diagnostic criteria used. The 
prevalence rates with WHO were 44.8%, 39.7% with revised NCEP-ATP, 33.1% with JIS, and 
31.6% with JIS. NCEP-ATP scored 29.3%, while IDF scored 29.3%. Although no statistically- 

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Table 4. Representation of study participants according to alcohol or tobacco consumption 
and physical activity 

Settings   Workforce Percentage (%) 

Physical activity No 67  58.30% 

Yes 48 41.70% 

Total 115 100.0% 

- significant difference was found, the higher prevalence obtained with IDF definition in study 
could be attributed to the fact that, unlike the other definitions, this definition includes BMI as 
a diagnostic criterion for MS, which is the most important risk factor in the African population.10 

In Chad, despite the seriousness of MS, we have little data on its prevalence. We found in this 
study which aimed to determine the prevalence of MS a rate of 72.2% (Figure 2) this result 
agrees with the data of the literature. In Burkina, in a study by.11 The association diabetes 
mellitus and metabolic syndrome was reported in 48.9% among type 2 diabetic subjects. 
According to,12 the prevalence of metabolic syndrome varies from 34% to 80% among 
diabetics, thus reflecting the importance of the problem. 

Our results are much higher than those reported in Côte d'Ivoire (4.94%).13 On the other hand, 
prevalence approaching ours were found in France (20%)14 as well as in Kuwait (39.19%).15 
The gender distribution of MS prevalence showed that women had a higher prevalence 
(71.08%) than men (28.91%) (Table 2). Previous studies conducted on the African continent 
have shown similar results.16,17 This could be explained by the obesity epidemic, which is a 
major risk factor for MS and predominantly affects women.22 Menopause, polycystic ovarian 
syndrome, and low physical activity are additional risk factors that could explain this high 
prevalence in this population group, indeed in Chad women are faced with multiple challenges, 
particularly in terms of access to education, physical activities and health services (Unesco 
2016). This result agrees with the work of Ba. (2012) in Senegal who found a frequency of 
58% in the type 2 diabetic population. This trend has been reported in Tunisia.23 However, a 
higher prevalence among men has been reported in Dakar.24 On the other hand, no significant 
difference was observed between the two sexes in Greece.25 Thus, the distribution of the 
prevalence of MS according to sex differs from one study to another. 

The average age of the participants was 60 years old with extremes ranging from 30 to 80 
years old. The predominant age group was 50-70 years old with a frequency of 67.8% (with 
33.9% from 50-60 years old and 33.9% from 60-70 years old) this could be explained by aging 
of the population studied. This increase in the prevalence of MS with age is therefore in 
agreement with the data in the literature. It could be linked to the higher frequency of metabolic 
disturbances in the elderly,26 However, the emergence of MS in adolescents should be noted, 
as evidenced by studies carried out in the United States,12 and in Canada.23,27 According to 
these authors, obesity would play an essential role. 

According to the number of associated criteria, we found in most subjects presenting MS, the 
association of 3 criteria (34%) (Table 3). These results control the data from the literature 
which shows that the association of three components is always the most frequent.28 However, 
it is important to note that 19 subjects (17%) of the total population already presented 2 criteria 
(Table 3). These should be carefully monitored to avoid progression to metabolic syndrome. 

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Nevertheless, our study had some limitations, namely: its short duration which did not allow 
us to investigate other possible factors that could be associated with the metabolic syndrome; 
the difficulty of collecting anthropometric data in some patients (ethical and religious problem) 
and the lack of additional examinations (lipidogram) often necessary for diagnosis. Moreover, 
our sample does not reflect all strata of Chadian society. 

A multicenter study should therefore be considered to have exact figures on the prevalence of 
MS in Chad. 

CONCLUSION 
At the end of this study, the objective of which was to assess the prevalence of the metabolic 
syndrome, the results show a high prevalence of MS in the population studied, particularly 
among women. The metabolic syndrome, in view of the entities that compose it, makes it a 
real cardiovascular risk factor and therefore a major public health issue. The management of 
this metabolic syndrome requires emphasizing the proper monitoring of diet and physical 
activity in addition to drug treatment for a significant improvement in the various parameters. 

Acknowledgment 

We thank Pr GATSING Donatien, Professor at the Université Evangelique du Cameroun, for 
his help in updating the subject of study, Pr TAGNE SIMO Richard, Senior Lecturer at the 
University of Ngaoundéré, for his ideas and above all his availability during the study; the 
Director of the CHU “le bon Samaritain” for giving us permission to carry out the study in his 
institution.  

Declarations 

Authors' contribution 

ZAN, BBO and VC designed this survey. SNY, KD, and AA, collected the original data. SNY, 
ADD and KD analyzed the data. NYS, AA, and KD, contributed to the interpretation of the 
data. ALDW, BBO, DDA, GC, NYS, and VC contributed to the writing of the article. SA, 
contributed equally to this study. All the authors have read, edited and contributed to the 
content of this manuscript.  

Funding statement 

 This research has not received external funding. 

Conflict of interest 

There is no conflict of interest in this research.  

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