Comparison of cardio metabolic risk factors and pre diabetes between urban and rural non-diabetic Lebanese adults

Abstract

Westernization and urbanization are leading to increases in the prevalence of the metabolic syndrome and consequently non-communicable diseases such as diabetes, which is often preceded by a stage of pre-diabetes. In this study, we intended to compare the prevalence of pre diabetes and other cardio metabolic risk factors between an urban and a rural area, to find the best components of the metabolic syndrome in predicting its prevalence, as well as compare the concordance between three pre-diabetes diagnostic tests (FBG, HbA1c, and 2-hour OGTT) and their association with other cardio metabolic risk factors. In across sectional design, a total of 160 adult Lebanese non-diabetic subjects were randomly selected from the visitors of the health centers of a rural (Arsal,Bekaa) and an urban area (Tarik Jdeede, Beirut) (80 non-diabetic, not pregnant, and not lactating subjects, aged 40to 60 years from each area, 40 from each gender). Socio-demographics of the two population samples were compared, and the best predictors among them of HbA1c and FBG were determined. The prevalence of cardio metabolic risk factors was compared between the two areas. The effect of each metabolic syndrome component on predicting its development was studied. The concordance between the three pre-diabetes tests was calculated using Roc curve and Kappa agreement. Pearson’s correlation coefficient correlations between the three pre-diabetes tests and those risk factors were calculated. Subjects from Arsal had significantly more children per family and lower salaries, were less educated, and less employed (p0.0001, p = 0.021, p = 0.003, and p0.0001 respectively). Area of residence, number of children, marital status, physical activity, and computer work were significant predictors of HbA1c and FBG. FBG and 2 hour BG glucose were significantly higher in Arsal as compared to Beirut (98.3 mg-dl vs. 90.6 mg-dl, p0.0001 and 90.6 mg-dl vs. 80.4 mg-dl, p 0.0001 respectively),while mean fasting plasma insulin and HbA1c were significantly hig