Influence Of Substance Use On The Development Of Metabolic Syndrome In The Semi-Urban Population Of Jimma Town, South West Ethiopia.

Background: Metabolic syndrome is a cluster of metabolically related cardiovascular disease (CVD) risk factors that increases the risk of CVDs by 2-fold and the risk of developing type 2 diabetes mellitus by 3-fold. Previous studies revealed that the development of metabolic syndrome and its components can be influenced by various life style factors. Metabolic syndrome can be determined in an individual by different criteria - proposed by international Diabetes Federation (IDF), National cholesterol Education programme-Adult Treatment panel (NCEP -ATP- III) and y WHO. Objective: The main objective of this study was to assess the influence of substance use on the development of metabolic syndrome among adults in Jimma town, South West Ethiopia as determined by IDF and NCEP ATP -III criteria. Methods: A community based cross-sectional study was conducted to assess the risk factors of Metabolic syndrome (Met S) by using IDF ( Met S IDF) and NCEP ATP III criteria (Met S ATP-III) . The study was conducted in accordance with the Stepwise approach of the World Health Organization. Interviewer administered questionnaires was used for basic data collection; anthropometric measurements such as height , weight ,waist circumference , BMI and blood pressure measurements(systolic /diastolic) were done; blood sample were collected; lipid profile such as total cholesterol, triglyceride ,HDL-C, LDL -C and plasma glucose analyses were done. The prevalence of metabolic syndrome was determined based on the IDF and ATP III definitions from the anthropometric measurements and biochemical estimations. The association between Met S and substance use such as smoking, alcohol, khat chewing and coffee drinking were verified by chi-square and regression analysis using SPSS version 19. Results and discussion: The population of Jimma town comprises of different ethnic, religious, economic, educational and occupational categories with variations in their life style habits. Cigarette smoking was directly associated with the development of Met S. Alcohol consumption was not significantly associated with Met S; moderate alcohol consumers are at a reduced risk of Met S compared to abstainers; consumption of wine was found to be inversely correlated with development of Met S (Met S IDF =0 % and Met S ATP III= 0 %); beer and local arrack (teje) consumption was directly associated with the development of Met S; heavy alcohol consumption was significantly associated with greater risk of developing Met S. Moderate khat chewers had shown a lesser prevalence of Met S compared to abstainers (Met S IDF: chewer =11%, non chewer=18.3% and Met S ATP III: chewer= 7.3, non chewer=11.4%); but heavy chewers had shown a significantly higher prevalence of Met S. Generally, coffee consumers had shown a less prevalence rate compared to abstainers (Met S IDF: coffee consumers =15.9%, non consumers=22.2% and % and Met S ATP III: coffee consumers =9.9%, non consumers=14.2%); moderate coffee consumption (4-6 cups/day) was associated with a reduced risk of Met S (Met S IDF =5.5% and Met S ATP III=3.7%). Logistic regression analysis revealed that cigarette smoking, not drinking coffee, are directly associated with the development of Metabolic syndrome IDF. Drinking alcohol every day (AOR=0.798), drinking beer (AOR=0.870), drinking local arrack (tejje) (AOR=0.578), taking any forms of alcohol for long duration (AOR=1.614) were also directly associated. Cigarette smoking habit is directly associated with the development of Metabolic syndrome ATP-III; drinking beer (AOR=0.752) and local arrack (tejje) (AOR=0.678) are also directly associated. Conclusions: Cigarette smoking was found to be a serious risk factor. Even though heavy alcoholism and heavy khat usage are risk factors, moderate alcoholism, occasional Khat chewing and moderate coffee drinking were all found to reduce the risk of being affected with Met S compared to abstainers.