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01-06-2020 | Dyslipidemia | IM - REVIEW

Cardio-metabolic risk factors in Tunisia: state of the art

Published in: Internal and Emergency Medicine | Issue 4/2020

Abstract

Cardiometabolic risk factors in Tunisia are growing fast. The main risk factor is metabolic syndrome which is a global health issue in both developing and developed countries. It is resulting from a new phase of epidemiological transition characterised by ageing and an increase in non-communicable diseases. It is common in both genders with some disparities between urban and rural regions, educational levels and social classes. Hypertension and diabetes are also additional risk factors predicting alarming mortality rates. We propose here a review of the determinants of metabolic syndrome in Tunisia and the overall cardiometabolic risk factors.

Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA et al (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 112(17):2735–2752CrossRefPubMed

Isomaa B, Almgren P, Tuomi T, Forsèn B, Lahti K, Nissèn M et al (2001) Cardio-vascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 24(4):683–689CrossRefPubMed

Mittal BV, Singh AK (2010) Hypertension in the developing world: challenges and opportunities. Am J Kidney Dis 55(3):590–598CrossRefPubMed

Ben Romdhane H, Haouala H, Belhani A, Drissa H, Kafsi N, Boujnah R et al (2005) Epidemiological transition and health impact of cardiovascular disease in Tunisia. Tunis Med 83(Suppl 5):1–7PubMed

Allal-Elasmi M, Haj Taieb S, Hsairi M, Zayani Y, Omar S, Sanhaji H et al (2010) The metabolic syndrome: prevalence, main characteristics and association with socio-economic status in adults living in Great Tunis. Diabetes Metab 36(3):204–208CrossRefPubMed

National Institute of Statistics (2015) Yearly statistics report. National Institute of Statistics, Tunis

Aounallah-Skhiri H, Romdhane HB, Traissac P, Eymard-Duvernay S, Delpeuch F, Achour N et al (2008) Nutritional status of Tunisian adolescents: associated gender, environmental and socio-economic factors. Public Health Nutr 11(12):1306–1317CrossRefPubMed

Institut National de la Nutrition et de la Technologie Alimentaire (1998) Evaluation de l’état nutritionnel de la population tunisienne 1996–1997. Rapport National. Tunis: INNTA

Belfki H, Ben Ali S, Aounallah-Skhiri H, Traissac P, Bougatef S, Maire B et al (2013) Prevalence and determinants of the metabolic syndrome among Tunisian adults: results of the Transition and Health Impact in North Africa (TAHINA) project. Public Health Nutr 16(4):582–590CrossRefPubMed

10.

Harzallah F, Alberti H, Ben Khalifa F (2006) The metabolic syndrome in an Arab population: a first look at the new International Diabetes Federation criteria. Diabet Med 23(4):441–444CrossRefPubMed

11.

Jaber LA, Brown MB, Hammad A, Zhu Q, Herman WH (2004) The prevalence of the metabolic syndrome among Arab Americans. Diabetes Care 27(1):234–238CrossRefPubMed

12.

Tamashiro KL (2011) Metabolic syndrome: links to social stress and socioeconomic status. Ann N Y Acad Sci 1231:46–55CrossRefPubMed

13.

Gannar F, de León AC, Díaz BB, Pérez MD, Rodríguez IM, Dahmen FB et al (2015) Social class and metabolic syndrome in populations from Tunisia and Spain. Diabetol Metab Syndr 7:88CrossRefPubMedPubMedCentral

14.

Aounallah-Skhiri H, El Ati J, Traissac P, Ben Romdhane H, Eymard-Duvernay S, Delpeuch F et al (2012) Blood pressure and associated factors in a North African adolescent population. A National Cross-Sectional Study in Tunisia. BMC Public Health 12:98CrossRefPubMedPubMedCentral

15.

Ben Romdhane H, Ben Ali S, Aissi W, Traissac P, Aounallah-Skhiri H, Bougatef S et al (2014) Prevalence of diabetes in Northern African countries: the case of Tunisia. BMC Public Health 14:86CrossRefPubMedPubMedCentral

16.

El Ati J, Traissac P, Delpeuch F, Aounallah-Skhiri H, Béji C, Eymard-Duvernay S et al (2012) Gender obesity inequities are huge but differ greatly according to environment and socio-economics in North African setting: a national cross-sectional study in Tunisia. PLoS ONE 7(10):e48153CrossRefPubMedPubMedCentral

17.

Regaieg S, Charfi N, Kamoun S, Eulleuch M, Marrakchi R, Jamoussi K et al (2015) Prevalence of metabolic syndrome and its components among overweight and obese secondary school adolescent in SFAX, Tunisia. Int J Clin Nutr 3(1):1–6CrossRef

18.

Jamoussi H, Mahjoub F, Sallemi H, Berriche O, Ounaissa K, Amrouche C et al (2012) Metabolic syndrome in Tunisian obese children and adolescents. Tunis Med 90(1):36–40PubMed

19.

Romdhane HB, Ali SB, Skhiri H, Traissac P, Bougatef S, Maire B et al (2012) Hypertension among Tunisian adults: results of the TAHINA project. Hypertens Res 35(3):341–347CrossRefPubMed

20.

Allal-Elasmi M, Feki M, Zayani Y, Hsairi M, Taieb SH, Jemaa R et al (2012) Prehypertension among adults in Great Tunis region (Tunisia): a population-based study. Pathol Biol (Paris) 60(3):174–179CrossRef

21.

Ibrahim MM, Rizk H, Appel LJ, el Aroussy W, Helmy S, Sharaf Y et al (1995) Hypertension prevalence, awareness, treatment, and control in Egypt. Results from the Egyptian National Hypertension Project (NHP). NHP investigative team. Hypertension 26(6 Pt 1):886–890CrossRefPubMed

22.

Mbanya JC, Minkoulou EM, Salah JN, Balkau B (1998) The prevalence of hypertension in rural and urban Cameroon. Int J Epidemiol 27:181–185CrossRefPubMed

23.

Agyemang C (2006) Rural and urban differences in blood pressure and hypertension in Ghana, West Africa. Public Health 120:525–533CrossRefPubMed

24.

Wu Y, Huxley R, Li L, Anna V, Xie G, Yao C et al (2008) Prevalence, awareness, treatment, and control of hypertension in China: data from the China National Nutrition and Health Survey 2002. Circulation 118(25):2679–2686CrossRefPubMed

25.

Ahmad K, Jafar TH (2005) Prevalence and determinants of blood pressure screening in Pakistan. J Hypertens 23(11):1979–1984CrossRefPubMed

26.

Al-Nozha MM, Abdullah M, Arafah MR, Khalil MZ, Khan NB, Al-Mazrou YY et al (2007) Hypertension in Saudi Arabia. Saudi Med J 28(1):77–84PubMed

27.

Rampal L, Rampal S, Azhar MZ, Rahman AR (2008) Prevalence, awareness, treatment and control of hypertension in Malaysia: a national study of 16,440 subjects. Public Health 122(1):11–18CrossRefPubMed

28.

Dorobantu M, Darabont RO, Badila E, Ghiorghe S (2010) Prevalence, awareness, treatment, and control of hypertension in Romania: results of the SEPHAR study. Int J Hypertens. https://doi.org/10.4061/2010/970694 CrossRefPubMedPubMedCentral

29.

McNiece KL, Poffenbarger TS, Turner JL, Franco KD, Sorof JM, Portman RJ (2007) Prevalence of hypertension and pre-hypertension among adolescents. J Pediatr 150(6):640–644 (644.e1) CrossRefPubMed

30.

Falkner B (2010) Hypertension in children and adolescents: epidemiology and natural history. Pediatr Nephrol 25(7):1219–1224CrossRefPubMed

31.

Pall D, Katona E, Paragh G, Zrinyi M, Zatik J, Fulesdi B (2005) Epidemiological data of 15–18 years adolescents and the prevalence of hypertension in Debrecen. The DebrecenHypertension Study. Orv Hetil 146(3):127–132PubMed

32.

Rosa ML, Fonseca VM, Oigman G, Mesquita ET (2006) Arterial prehypertension and elevated pulse pressure in adolescents: prevalence and associated factors. Arq Bras Cardiol 87(1):46–53CrossRefPubMed

33.

Kollias A, Antonodimitrakis P, Grammatikos E, Chatziantonakis N, Grammatikos EE, Stergiou GS (2009) Trends in high blood pressure prevalence in Greek adolescents. J Hum Hypertens 23(6):385–390CrossRefPubMed

34.

Andrade H, Antonio N, Rodrigues D, Da Silva M, Pego M, Providencia LA (2010) High blood pressure in the pediatric age group. Rev Port Cardiol 29(3):413–432PubMed

35.

Drukteinis JS, Roman MJ, Fabsitz RR, Lee ET, Best LG, Russell M et al (2007) Cardiac and systemic hemodynamic characteristics of hypertension and prehypertension in adolescents and young adults: the Strong Heart Study. Circulation 115(2):221–227CrossRefPubMed

36.

Bouguerra R, Alberti H, Ben Salem L, Ben Rayana C, El Atti J, Gaigi S et al (2007) The global diabetes pandemic: the Tunisian experience. Eur J Clin Nutr 61(2):160–165CrossRefPubMed

37.

Al-Lawati JA, Al Riyami AM, Mohammed AJ, Jousi Lahti P (2002) Increasing prevalence of DM in Oman. Diabet Med 19(11):954–957CrossRefPubMed

38.

Bener A, Zirie M, Janahi IM, Al-Hamaq A, Musallam M, Wareham NJ (2009) Prevalence of diagnosed and undiagnosed diabetes mellitus and its risk factors in a population-based study of Qatar. Diabetes Res Clin Pract 84(1):99–106CrossRefPubMed

39.

Ben Romdhane H, Khaldi R, Oueslati A, Skhiri H (2002) Epidemiologic and nutritional transition in Tunisia. Opt Méditerranéennes 41:278

40.

Harzallah F, Ncibi N, Alberti H, Ben Brahim A, Smadhi H, Kanoun F et al (2006) Clinical and metabolic characteristics of newly diagnosed diabetic patients: experience of a University Hospital in Tunis. Diabetes Metab 32(6):632–635CrossRefPubMed

41.

Jomaa W, El Mhamdi S, Ali IB, Azaiez MA, El Hraiech A, Hamda KB et al (2018) Prognostic value of hyperglycemia on-admission in diabetic versus non-diabetic patients presenting for ST-elevation myocardial infarction in Tunisia. Indian Heart J 70(6):772–776CrossRefPubMedPubMedCentral

42.

Saidi O, O'Flaherty M, Mansour NB, Aissi W, Lassoued O, Capewell S et al (2015) Forecasting Tunisian type 2 diabetes prevalence to 2027: validation of a simple model. BMC Public Health 15:104CrossRefPubMedPubMedCentral

43.

Saidi O, Malouche D, O’Flaherty O, Mansour NB, Skhiri HA, Romdhane HB et al (2016) Assessment of cardiovascular risk in Tunisia: applying the Framingham risk score to national survey data. BMJ Open 6:e009195CrossRefPubMedPubMedCentral

44.

Yahia-Berrouiguet A, Benyoucef M, Meguenni K, Brouri M (2009) Enquête sur la prévalence des facteurs de risque de maladies cardiovasculaires à Tlemcen (Algérie). Médecine des maladies métaboliques 3:313–319CrossRef

45.

Baynouna LM, Revel AD, Nagelkerke NJ, Jaber TM, Omar AO, Ahmed NM et al (2008) High prevalence of the cardiovascular risk factors in Al Ain, United Arab Emirates. Saudi Med J 29(8):1173–1178PubMed

46.

Galán AM, García FA, Taix MF, Ros XA, Martí EA, Gil AC (2004) Cardiovascular risk of SCORE compared to Framingham: consequences of the change proposed by the European Societies. Med Clin (Barc) 123:681–685CrossRef

47.

Ezzati M, Vander Hoorn S, Lawes CM, Leach R, James WP, Lopez AD et al (2005) Rethinking the “diseases of affluence” paradigm: global patterns of nutritional risks in relation to economic development. PLoS Med 2(5):e133CrossRefPubMedPubMedCentral

48.

Kreatsoulas C, Anand S (2010) The impact of social determinants on cardiovascular disease. Can J Cardiol 26(Suppl C):8C–13CCrossRefPubMedPubMedCentral

49.

Dallongeville J, Cottel D, Wagner A, Ducimetière P, Ruidavets J-B, Arveiler D et al (2008) The APOA5 Trp19 allele is associated with metabolicsyndrome via its association with plasma triglycerides. BMC Med Genet 9:84CrossRefPubMedPubMedCentral

50.

Demirdöğen BC, Şahin E, Özçelik AT, Bek S, Demirkaya Ş, Adali O (2012) Apolipopro-tein A5 polymorphisms in Turkish population: association with serum lipidprofile and risk of ischemic stroke. Mol Biol Rep 39(12):10459–10468CrossRef

51.

Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M et al (2018) The 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 39(33):3021–3104CrossRefPubMed

52.

Takeuchi F, Isono M, Katsuya T, Yokota M, Yamamoto K, Nabika T et al (2012) Association of genetic variants influencing lipid levels with coronary arterydisease in Japanese individuals. PLoS ONE 7:9

53.

Tan A, Sun J, Xia N, Qin X, Hu Y, Zhang S et al (2012) A genome-wide associa-tion and gene-environment interaction study for serum triglycerides levelsin a healthy Chinese male population. Hum Mol Genet 21:1658–1664CrossRefPubMed

54.

Sarbakhsh P, Mehrabi Y, Daneshpour MS, Zayeri F, Zarkesh M (2013) Logicregression analysis of association of gene polymorphisms with low HDL: tehran lipid and glucose study. Gene 513:278–281CrossRefPubMed

55.

Kefi R, Hechmi M, Dallali H, Elouej S, Jmel H, Halima YB et al (2017) Association of apolipoprotein A5 gene variants with metabolic syndrome in Tunisian population. Ann Endocrinol (Paris) 78(3):146–155CrossRef

56.

Wu Y, Yu Y, Zhao T, Wang S, Fu Y, Qi Y et al (2016) Interactions of environmental factors and APOA1–APOC3–APOA4–APOA5 gene cluster genepolymorphisms with metabolic syndrome. PLoS ONE 11:e0147946CrossRefPubMedPubMedCentral

57.

Cha S, Yu H, Park AY, Song KH (2014) Effects of apolipoprotein A5 haplotypeson the ratio of triglyceride to high-density lipoprotein cholesterol and therisk for metabolic syndrome in Koreans. Lipids Health Dis 13:1–7CrossRefPubMedCentral

58.

Qi L, Liu S, Rifai N, Hunter D, Hu FB (2006) Associations of the apolipoproteinA1/C3/A4/A5 gene cluster with triglyceride and HDL cholesterol levels inwomen with type 2 diabetes. Atherosclerosis 192(1):204–210CrossRefPubMed

59.

Grigorescu F (2012) New genetic approaches in understanding susceptibility for metabolic syndrome in immigrant populations around mediterranean area. Acta Endocrinol-Buch 8(1):87–98

60.

Elouej S, Rejeb I, Attaoua R, Nagara M, Sallem OK, Kamoun I et al (2016) Gender-specific associations of genetic variants with metabolic syndrome components in the Tunisian population. Endocr Res 41(4):300–309CrossRefPubMed

61.

Elouej S, Belfki-Benali H, Nagara M, Lasram K, Attaoua R, Sallem OK et al (2016) Association of rs9939609 polymorphism with metabolic parameters and FTO risk haplotype among Tunisian Metabolic Syndrome. Metab Syndr Relat Disord 14(2):121–128CrossRefPubMed

62.

Elouej S, Nagara M, Attaoua R, Sallem OK, Rejeb I, Hsouna S et al (2016) Association of genetic variants in the FTO gene with metabolic syndrome: a case-control study in the Tunisian Population. J Diabetes Complications 30(2):206–211CrossRefPubMed

Title: Cardio-metabolic risk factors in Tunisia: state of the art
Publication date: 01-06-2020
Keywords: Dyslipidemia
Hypertension
Hypertension
Type 2 Diabetes
Published in: Internal and Emergency Medicine / Issue 4/2020
Print ISSN: 1828-0447
Electronic ISSN: 1970-9366
DOI: https://doi.org/10.1007/s11739-019-02164-7

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