OBJECTIVE Developing countries are undergoing an epidemiologic transition accompanied by increasing burden of cardiovascular disease (CVD) linked to urbanization and lifestyle modifications. Metabolic syndrome is a cluster of CVD risk factors whose extent in Kenya remains unknown. The aim of this study was to determine the prevalence of metabolic syndrome and factors associated with its occurrence among an urban population in Kenya.

RESEARCH DESIGN AND METHODS This was a household cross-sectional survey comprising 539 adults (aged =18 years) living in Nairobi, drawn from 30 clusters across five socioeconomic classes. Measurements included waist circumference, HDL cholesterol, triacylglycerides (TAGs), fasting glucose, and blood pressure.

RESULTS The prevalence of metabolic syndrome was 34.6% and was higher in women than in men (40.2 vs. 29%; P < 0.001). The most frequently observed features were raised blood pressure, a higher waist circumference, and low HDL cholesterol (men: 96.2, 80.8, and 80%; women: 89.8, 97.2, and 96.3%, respectively), whereas raised fasting glucose and TAGs were observed less frequently (men: 26.9 and 63.3%; women: 26.9 and 30.6%, respectively). The main factors associated with the presence of metabolic syndrome were increasing age, socioeconomic status, and education.

CONCLUSIONS Metabolic syndrome is prevalent in this urban population, especially among women, but the incidence of individual factors suggests that poor glycemic control is not the major contributor. Longitudinal studies are required to establish true causes of metabolic syndrome in Kenya. The Kenyan government needs to create awareness, develop prevention strategies, and strengthen the health care system to accommodate screening and management of CVDs.

The global prevalence of leading chronic diseases is increasing, with the majority occurring in low- and middle-income countries, and expected to rise substantially over the next two decades (1). Chronic diseases are responsible for 50% of the total disease burden, with estimated age-standardized death rates being higher for men and women from low-income compared to middle-income countries (2). Major causes are said to be increasing rates of hypertension, dyslipidemia, diabetes, obesity, physical inactivity, and tobacco use.

Kenya is a rapidly developing country of sub-Saharan Africa, where the extent of most cardiovascular diseases (CVDs) and the associated risk factors at population level remain largely unknown. Chronic diseases have not received much attention due to overemphasis on communicable diseases, underreporting, missed diagnosis, misdiagnosis, and misclassification of diseases. According to the Ministry of Health Annual Status Report 2007, the leading causes of deaths in Kenya are malaria, pneumonia, HIV/AIDS, diarrhea, anemia, tuberculosis, meningitis, and heart failure. However, noncommunicable diseases (NCDs) contribute over one-half of the top 20 causes of morbidity and mortality (3). Total mortality attributed to NCDs rose from 31.8% in 2002 to 33% in 2007. This has been attributed to urbanization that brings with it changes in lifestyle that adversely affect metabolism.

In 1993, a hospital-based study in Nairobi found high prevalence of obesity, hypercholesterolemia, cigarette smoking, and electrocardiogram evidence of left ventricular hypertrophy, with hypertension as the most common discharge diagnosis (4). A study by Christensen et al. (5) found the prevalence of overweight (BMI =25 kg/m2) at 39.8 vs. 15.8% and obesity (BMI =30 kg/m2) at 15.5 vs. 5.1% among urban versus rural Kenyan populations, respectively. The same study observed an overall age-standardized prevalence of diabetes and impaired glucose tolerance of 4.2 and 12.0%, respectively (6). These findings, in addition to the prevailing global understanding of CVDs, call for screening and early detection of metabolic abnormalities to help identify people who are at risk and most likely to benefit from intervention efforts.

The term metabolic syndrome refers to the clustering of a number of cardiovascular risk factors (obesity, hypertension, dyslipidemia, and hyperglycemia) believed to be related to insulin resistance. It is estimated that ~20–25% of the world’s adult population have metabolic syndrome, and they are twice as likely to die of and three times as likely to have a heart attack or stroke compared with people without the syndrome. In addition, people with metabolic syndrome have a fivefold greater risk of developing type 2 diabetes (7). The aim of this study was to determine the prevalence and factors associated with the occurrence of metabolic syndrome among an urban population in Kenya.