Objectives: The aim of this study was to determine the prevalence of MetS among different African populations using the new Joint Statement Criteria. Hereafter we aimed to determine whether waist or neck circumference is the best predictor of MetS risk after ethnic, gender and age-specific cut-points were developed. Lastly, we aimed to determine whether afore-mentioned cut-point can predict albumin:creatinine ratio as a marker of target organ damage. Methods: The study sample (N=409) comprised of urban African (men, N=101; women, N=99) and Caucasian (men, N=101; women, N=108) teachers from the Dr. Kenneth Kaunda Education district in the North-West Province, South Africa. Participants were aged between 25 and 65 years. Anthropometric measurements, albumin:creatinine ratio and other markers of the metabolic syndrome (MetS) (systolic and diastolic blood pressure [SBP and DBP], glucose, triglycerides [TG] and high density lipoprotein [HDL]) were determined. Results: Africans (65 and 63 % for men and women) and Caucasian men (73%) showed high prevalence of MetS; ROC analysis determined neck circumference (NC) cut-points of 39 and 35 cm for young and older African men, 32 and 35 cm for young and older African women, 40 and 41 cm for Caucasian men and 34 and 33 cm for Caucasian women. This NC cut-point can be used to determine metabolic syndrome risk in all groups, except in African women; ROC developed waist circumference (WC) cut-points were 91 cm for all African male groups, 84, 81 and 84 cm for young, older and total group of African women. Suggested WC cut-points for Caucasian men were 93 cm for the young group and 97 cm for older as well as total Caucasian male groups, while cut-points for Caucasian women were 87 cm, 79 cm and 84 cm for young, older and total Caucasian women. These WC cut-points were good measures of metabolic syndrome risk in all groups; neither cut-point of WC nor NC could increase the risk of albumin:creatinine ratio. Conclusion: African women as a group present with few MetS risk factors and glucose is associated with renal function risk in Africans; NC cut-points may be used as an additional anthropometric marker to predict the metabolic syndrome in a South African cohort, but not in African women; WC cutpoints demonstrated to be good predictors of the metabolic syndrome in the same South African cohort, especially among men; WC would seem to be the best measure of MetS risk in all African populations, although NC can also be used for this purpose in all African populations, except in African women. / Thesis (PhD (Human Movement Science))--North-West University, Potchefstroom Campus, 2012

Objectives: The aim of this study was to determine the prevalence of MetS among different African populations using the new Joint Statement Criteria. Hereafter we aimed to determine whether waist or neck circumference is the best predictor of MetS risk after ethnic, gender and age-specific cut-points were developed. Lastly, we aimed to determine whether afore-mentioned cut-point can predict albumin:creatinine ratio as a marker of target organ damage. Methods: The study sample (N=409) comprised of urban African (men, N=101; women, N=99) and Caucasian (men, N=101; women, N=108) teachers from the Dr. Kenneth Kaunda Education district in the North-West Province, South Africa. Participants were aged between 25 and 65 years. Anthropometric measurements, albumin:creatinine ratio and other markers of the metabolic syndrome (MetS) (systolic and diastolic blood pressure [SBP and DBP], glucose, triglycerides [TG] and high density lipoprotein [HDL]) were determined. Results: Africans (65 and 63 % for men and women) and Caucasian men (73%) showed high prevalence of MetS; ROC analysis determined neck circumference (NC) cut-points of 39 and 35 cm for young and older African men, 32 and 35 cm for young and older African women, 40 and 41 cm for Caucasian men and 34 and 33 cm for Caucasian women. This NC cut-point can be used to determine metabolic syndrome risk in all groups, except in African women; ROC developed waist circumference (WC) cut-points were 91 cm for all African male groups, 84, 81 and 84 cm for young, older and total group of African women. Suggested WC cut-points for Caucasian men were 93 cm for the young group and 97 cm for older as well as total Caucasian male groups, while cut-points for Caucasian women were 87 cm, 79 cm and 84 cm for young, older and total Caucasian women. These WC cut-points were good measures of metabolic syndrome risk in all groups; neither cut-point of WC nor NC could increase the risk of albumin:creatinine ratio. Conclusion: African women as a group present with few MetS risk factors and glucose is associated with renal function risk in Africans; NC cut-points may be used as an additional anthropometric marker to predict the metabolic syndrome in a South African cohort, but not in African women; WC cutpoints demonstrated to be good predictors of the metabolic syndrome in the same South African cohort, especially among men; WC would seem to be the best measure of MetS risk in all African populations, although NC can also be used for this purpose in all African populations, except in African women. / Thesis (PhD (Human Movement Science))--North-West University, Potchefstroom Campus, 2012

Objetivo. Ao mesmo tempo em que a obesidade aumenta no mundo todo e se torna cada vez mais um problema de Saúde Pública, o stress aumenta no cotidiano das pessoas e na busca pela sobrevivência. Verificar a possível associação entre prevalências de obesidade centralizada e indicadores de stress é o objetivo desse trabalho. Métodos. Utilizam-se dados de um estudo transversal, com informações de 298 mulheres de 20 a 59 anos, moradoras de um município da Grande São Paulo, as quais responderam questionários especialmente elaborados para avaliar o stress psicológico. O diagnóstico de obesidade centralizada foi feito através da medida da circunferência da cintura (CC) e da razão cinturaquadril (RCQ). O stress psicológico foi medido em escores atribuídos às respostas dos questionários e classificado em 3 categorias: isento, resistência e exaustão. A análise estatística foi realizada mediante dois modelos de regressão linear generalizada múltipla entre a variável resposta obesidade centralizada em duas categorias (sim, não) e o stress psicológico em três fases (isento, resistência e exaustão), controlando-se as variáveis demográficas: idade e escolaridade. Resultados. As prevalências de obesidade centralizada foram semelhantes nos dois modelos, respectivamente 40,6 % e 42% para CC e RCQ. As prevalências de stress psicológico foram 61,7% e 8,4% para as fases resistência e exaustão. As associações entre a categoria sim foram positivas e significantes, respectivamente para CC e RCQ (RP 1,51, P 0,028 e RP 1,52, P 0,022) com o stress na fase de exaustão, com o aumento da idade (RP 1,02, P 0,001 e RP 1,01, P 0,002) e com baixa escolaridade (RP 0,67, P 0,030 e RP 0,59, P 0,005). O teste de tendência foi positivo (P 0,029) para a categoria sim do RCQ e aumento das categorias de stress. Conclusões. A fase de exaustão do stress mostrou associação positiva e significante com a obesidade centralizada nos dois modelos estudados, CC e RCQ. O teste significante de tendência com a RCQ sugere efeito gradativo das fases do stress sobre a obesidade centralizada. São necessários, no entanto, outros estudos que comprovem a associação da obesidade centralizada com o stress subdividido em categorias. / Objective. When observing modern life nowadays we find out that, at the same time that obesity increases all around the world and becomes a real concern to public health authorities, we also see stress proliferating in peoples everyday life, specially in the fight for survival. The purpose of this work is to verify the association between prevalence of abdominal obesity and stress indicators. Methods. This work uses given data of a transversal study, containing information of 298 women aged between 20 and 59, inhabitants of the Great São Paulo, who had been submitted to questionnaires especially formulated to evaluate psychological stress. The diagnosis of abdominal obesity was made using two models: measuring Waist Circumference (WC) and Waist - Hip ratio (WHR). Psychological stress was measured in scores attributed to answers of the questionnaires and classified in 3 categories: Exempt, Resistance and Exhaustion. The statistics analysis were carried through two models of multiple generalized linear regression between the variable which is the answer- abdominal obesity focused in two categories (Yes, No) and psychological stress focused in three categories (Exempt, Resistance, Exhaustion) maintaining under control the demographic variables such as age and scholarship. Results. The results referring to the prevalence of abdominal obesity were similar in the two models showing respectively 40.6% and 42% for WC and WHR. The results on the prevalence of psychological stress were 61.7% and 8.4% respectively for the phase of Resistance and the phase of Exhaustion. The associations in the Yes category were classified as being positive and significant, for WC and WHR respectively, Prevalence Ratio PR 1,51, significancy P 0,028 and PR 1,52, P 0,022 for the stress in the phase of Exhaustion, when considered also an increase in age (PR 1,02, P 0,001 and PR 1,01, P 0,002) and a decrease in the level of education (PR 0,67, P 0,030 and PR 0,59, P 0,005) The trend analysis was positive (P 0,029) for the increase of the WHR and the categories of stress. Conclusions. The phase of Exhaustion of Stress showed positive and significant association with the Abdominal Obesity in the two models, WC and WHR. The positive results in the trend tests with the WHR suggest that abdominal obesity may be gradually affected by the phases of stress. Nevertheless, there is the need of further investigation to confirm the association between abdominal obesity and the various categories of stress.

Objetivo. Ao mesmo tempo em que a obesidade aumenta no mundo todo e se torna cada vez mais um problema de Saúde Pública, o stress aumenta no cotidiano das pessoas e na busca pela sobrevivência. Verificar a possível associação entre prevalências de obesidade centralizada e indicadores de stress é o objetivo desse trabalho. Métodos. Utilizam-se dados de um estudo transversal, com informações de 298 mulheres de 20 a 59 anos, moradoras de um município da Grande São Paulo, as quais responderam questionários especialmente elaborados para avaliar o stress psicológico. O diagnóstico de obesidade centralizada foi feito através da medida da circunferência da cintura (CC) e da razão cinturaquadril (RCQ). O stress psicológico foi medido em escores atribuídos às respostas dos questionários e classificado em 3 categorias: isento, resistência e exaustão. A análise estatística foi realizada mediante dois modelos de regressão linear generalizada múltipla entre a variável resposta obesidade centralizada em duas categorias (sim, não) e o stress psicológico em três fases (isento, resistência e exaustão), controlando-se as variáveis demográficas: idade e escolaridade. Resultados. As prevalências de obesidade centralizada foram semelhantes nos dois modelos, respectivamente 40,6 % e 42% para CC e RCQ. As prevalências de stress psicológico foram 61,7% e 8,4% para as fases resistência e exaustão. As associações entre a categoria sim foram positivas e significantes, respectivamente para CC e RCQ (RP 1,51, P 0,028 e RP 1,52, P 0,022) com o stress na fase de exaustão, com o aumento da idade (RP 1,02, P 0,001 e RP 1,01, P 0,002) e com baixa escolaridade (RP 0,67, P 0,030 e RP 0,59, P 0,005). O teste de tendência foi positivo (P 0,029) para a categoria sim do RCQ e aumento das categorias de stress. Conclusões. A fase de exaustão do stress mostrou associação positiva e significante com a obesidade centralizada nos dois modelos estudados, CC e RCQ. O teste significante de tendência com a RCQ sugere efeito gradativo das fases do stress sobre a obesidade centralizada. São necessários, no entanto, outros estudos que comprovem a associação da obesidade centralizada com o stress subdividido em categorias. / Objective. When observing modern life nowadays we find out that, at the same time that obesity increases all around the world and becomes a real concern to public health authorities, we also see stress proliferating in peoples everyday life, specially in the fight for survival. The purpose of this work is to verify the association between prevalence of abdominal obesity and stress indicators. Methods. This work uses given data of a transversal study, containing information of 298 women aged between 20 and 59, inhabitants of the Great São Paulo, who had been submitted to questionnaires especially formulated to evaluate psychological stress. The diagnosis of abdominal obesity was made using two models: measuring Waist Circumference (WC) and Waist - Hip ratio (WHR). Psychological stress was measured in scores attributed to answers of the questionnaires and classified in 3 categories: Exempt, Resistance and Exhaustion. The statistics analysis were carried through two models of multiple generalized linear regression between the variable which is the answer- abdominal obesity focused in two categories (Yes, No) and psychological stress focused in three categories (Exempt, Resistance, Exhaustion) maintaining under control the demographic variables such as age and scholarship. Results. The results referring to the prevalence of abdominal obesity were similar in the two models showing respectively 40.6% and 42% for WC and WHR. The results on the prevalence of psychological stress were 61.7% and 8.4% respectively for the phase of Resistance and the phase of Exhaustion. The associations in the Yes category were classified as being positive and significant, for WC and WHR respectively, Prevalence Ratio PR 1,51, significancy P 0,028 and PR 1,52, P 0,022 for the stress in the phase of Exhaustion, when considered also an increase in age (PR 1,02, P 0,001 and PR 1,01, P 0,002) and a decrease in the level of education (PR 0,67, P 0,030 and PR 0,59, P 0,005) The trend analysis was positive (P 0,029) for the increase of the WHR and the categories of stress. Conclusions. The phase of Exhaustion of Stress showed positive and significant association with the Abdominal Obesity in the two models, WC and WHR. The positive results in the trend tests with the WHR suggest that abdominal obesity may be gradually affected by the phases of stress. Nevertheless, there is the need of further investigation to confirm the association between abdominal obesity and the various categories of stress.