The prevalence of non-communicable diseases (NCD) including obesity, diabetes and cardiovascular diseases is increasing in low and middle-income countries. Our purpose was to assess cardiometabolic risk (CMR) and the relationship between abdominal obesity (AO) and other CMR biomarkers in two urban population groups with a common African heritage but living in widely different settings, Cotonou (Benin, West Africa) and Port-au-Prince (Haiti).

The cross-sectional study included 452 apparently healthy men and women from Cotonou and Port-au-Prince (PAP) aged 25y to 60y and selected by cluster random sampling. We used the definition of the International Diabetes Federation for the metabolic syndrome (MetS) including the generic waist circumference cut-offs. Insulin resistance was set at the 75th centile of Homeostasis Model Assessment (HOMA-IR) for the whole sample of subjects. High atherogenicity index (total serum cholesterol/HDL-Cholesterol>4 in men, > 5 in women) and inflammation according to high-sensitivity C-reactive protein (hsCRP) were also assessed.

MetS prevalence was 21.5% and 16.1% in Cotonou and PAP, respectively. The most prevalent MetS components were low HDL-cholesterol, followed by AO and high blood pressure. AO was much higher in women than in men: 83% vs. 22% in Cotonou, and 67% vs. 9.6% in PAP. Insulin resistance and high atherogenicity index were roughly twice as prevalent in PAP as in Cotonou in spite of a lower AO prevalence in the former setting. High hsCRP was not significantly different (20.3% in Cotonou, 13.6% in PAP). Controlling for age and city, AO was independently associated with CMR biomarkers except for hyperglycemia and the association was much stronger in men than in women.

Although CMR was high in both settings, differential rates were noted for specific biomarkers; environmental determinants need to be investigated. Ethno-specific WC cut-offs for AO are needed particularly for women.