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What Are the Determinants of Insulin Resistance (IR) and How Effective Is the Sub-Saharan Africa-Specific Threshold of Abdominal Obesity (AO-SSA) Identifying IR in Congolese Black Hypertensive Patients?

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World Journal of Cardiovascular Diseases 2014年第13期4卷 642-654页

作者： bernard kianu phanzu Benjamin Longo-Mbenza Jean Bosco Kasiam Lasion’kin Jody Mbuilu Pukuta Eleuthère Kintoki Vita Nanoue Masolo Muze kianu Department of Internal Medicine Unit of Cardiology University of Kinshasa Hospital Kinshasa Democratic Republic of Congo Faculty of Health Sciences Walter Sisulu University Mthatha South Africa Department of Internal Medicine Unit of Endocrinology and Metabolism University of Kinshasa Hospital Kinshasa Democratic Republic of Congo Department of Family Medicine University of Witwatersrand Johannesburg South Africa Faculty of Medicine University of Technology Bel Campus Kinshasa Democratic Republic of Congo

Background: Hypertensive patients with insulin resistance (IR) are at greater risk of cardiovascular disease and may represent a particular subset of hypertension (HTN) requiring special medical attention. Quantitative measurements of the IR are not suitable for routine clinical practice. Met-abolic syndrome (MetS) or simply abdominal obesity (AO) is surrogate of IR. The performance of the recently proposed Sub-Saharan Africa cut-off point of abdominal obesity for identifying IR in hypertensive patients has never been evaluated. Aims: The main objective was to compare the performance of the newly proposed Sub-Saharan Africa specific threshold of abdominal obesity (AO-SSA) to that of IDF (AO-IDF) in identifying IR in Congolese Black Hypertensive Patients. Methods: A cross-sectional study was conducted at the Heart of Africa Cardiovascular Center, Lomo Medical Clinic, Kinshasa Limete, DR Congo, between January 2007 and January 2010. Homeostatic model assessment (HOMA) index was calculated to determine IR. Multivariate logistic regression analysis was used to assess the independent determinants of IR. The intrinsic (sensitivity and specificity) and extrinsic (positive predictive value and negative predictive value) characteristics of the AO-SSA, AO-IDF, AO-ATP III, MetS-SSA, MetS-IDF, and MetS-ATP III were calculated. The kappa statistic was determined for agreement between the ATPIII, IDF and SSA defined AO and MetS with HOMA-IR. Results: Men represented the majority of the enrolled patients: 105 (64.4%) and the mean age of all participants were 57 ± 11 years. Insulin resistance was found in 79.1% of the study population with 88.7, 79.3, 84.6, 71.4, 75.5, 91.1, 60.3 and 44.8 respectively among patient with MetS-ATP, MetS-IDF, MetS-SSA, AO-ATP III, AO-IDF, AO-SSA, diabetics and non-obese non-diabetic hypertensive patients. In multivariate analysis, the risk of IR was associated independently and significantly (p < 0.05) with cigarette smoking, low-HDL-C, hyperuricemia, and diastolic HTN, as shown in the following eq

关键词： Insulin Resistance Hypertension Sub-Saharan Africa Abdominal Obesity

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Lifestyle Changes for Abdominal Obesity Prevention and Encouraging Fruit Consumption May Be Beneficial in Preventing Left Ventricular Hypertrophy in Sub-Saharan African and Maghreb

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World Journal of Cardiovascular Diseases 2017年第2期7卷 46-56页

作者： Charifa Annis bernard kianu phanzu Sidibe Moussa Mustapha El Hattaoui Benzaroual Dounia Jean-René M’buyamba Kabangu Benjamin Longo-Mbenza Cardiology Unit CHU Mohammed VI Marrakech Kingdom of Morocco Unit of Cardiology University Hospital of Kinshasa Kinshasa Democratic Republic of Congo Faculty of Health Sciences Walter Sisulu University Mthatha Republic of South Africa

There is a growing body of evidence showing a close correlation between left ventricular mass with cardiovascular morbidity and overall mortality. Therefore, identifying the determinants of left ventricular hypertrophy can be of great importance for cardiovascular prevention, for prognosis and therapeutic intervention. Objective: To assess the prevalence and identify the independent determinants of echocardiographic left ventricular hypertrophy in The MA-Ghreb and Sub-Saharan Africa Left-Ventricul ArGEometry Study (MAG-SALVAGES) participants. Methods: The MAG-SALVAGES is a community based study in which 100 asymptomatic Black Sub-Saharan African (BSSA) and 189 white skin Maghreb within the age of 18 to 55 years underwent a resting echocardiography. Multivariate logistic regression analysis was utilized to identify the independent determinants of LVH left ventricular hypertrophy. Results: Men represented the majority of the enrolled participants: 173 (59.9%). Echocardiographic left ventricular hypertrophy was seen in 10 (3.5%) participants. Age ≥40 years, female gender, overall obesity, abdominal obesity, hypertension status and less fruit consumption were significantly associated with echocardiography left ventricular hypertrophy. After adjusting for confounding factors, age ≥40 years, female gender, abdominal obesity and less fruit consumption were independently and significantly associated with echocardiographic left ventricular hypertrophy, as illustrated in the following equation: Y = 0.36 + 0.162 age >40 years + 2.69 female gender + 2.52 abdominal obesity + 1.31 less fruit consumption. Conclusion: Lifestyle changes for the prevention of abdominal obesity and encouraging fruit consumption may be beneficial in preventing left ventricular hypertrophy.

关键词： Left Ventricular Hypertrophy Abdominal Obesity Diet Sub-Saharan African Maghreb

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The Influence of Ethnicity in the Relationship between Sedentary Screen Time and Left Ventricular Mass: Insights from the MAG-SALVAGES

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World Journal of Cardiovascular Diseases 2017年第2期7卷 11-23页

作者： Charifa Annis bernard kianu phanzu Moussa Sidibe Mustapha El Hattaoui Benzaroual Dounia Jean-Réné M’buyamba Kabangu Benjamin Longo-Mbenza Unit of Cardiology CHU Mohammed VI Cady Ayyad University Marrakech Kingdom of Morocco Unit of Cardiology University Hospital of Kinshasa Kinshasa Democratic Republic of Congo Faculty of Health Sciences Walter Sisulu University Mthatha Republic of South Africa

Background: The influence of race/ethnicity on the relationship between sedentary screen time and left ventricular mass has been recently suggested, but remains a subject of debate, and has never been explored in Africa. Purpose: To determine whether there is a racial/ethnic influence on the relationship between sedentary screen time and left ventricular mass in MAGhreb and Sub Saharan Africa Left-Ventricul ArGEometry Study (MAG-SALVAGES) participants. Methods: 100 blacks sub-Saharan African and 187 white Maghreb aged 18 - 55 years underwent an interview on their behavioral measures, physical activity and eating habits. Their left ventricular mass has also been measured by a resting transthoracic echography according to the American Society of Echography. Generalized linear models evaluated a test-for-trend across higher levels of sedentary screen time in progressive models with left ventricular measurements as dependent variables. The study population was stratified into quartiles of sedentary screen time (separately for whites and blacks) and examined the joint association of sedentary screen time and LVM within quartiles of physical activity. Results: Among White Maghreb, higher screen time was associated with smaller left ventricular mass (P Conclusions: Sedentary screen time is associated with smaller left ventricular mass in White Maghreb, not in black sub-Saharan African. The lack of association in blacks supports a potential qualitative difference in the cardiovascular consequences of sedentary screen based behavior.

关键词： Left Ventricular Mass Sedentary Ethnicity White Maghreb Black Sub-Saharan Africa

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Performance of the Peguero-Lo Presti Index in Diagnosis of Left Ventricular Hypertrophy at CIMAK Hospital Center in North Kivu, Democratic Republic of the Congo

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World Journal of Cardiovascular Surgery 2023年第2期13卷 11-25页

作者： Ferdinand Ng’ekieb Mukoso Aliocha Natuhoyila Nkodila Thierry-Samuel Mbuyi Muhemed Trésor Mosomo Kashinde Sévérin Juamungu Ananas Salomo Ndoole Myatsi Ariane Namwiza Gakuru Olivier Gasana Muratwa Zéphirin Tudienzelz Kamuanga Yves Lubenga bernard phanzu kianu Benjamin Longo-Mbenza Zacharie Kibendelwa Tsongo Department of Health Sciences Higher Institute of Medical Techniques of Bandundu Bandundu Democratic Republic of Congo Faculty of Medicine University of Goma Goma Democratic Republic of Congo Service of Cardiology International Clinic for Advanced Medicine in Kivu Goma Democratic Republic of Congo Department of Family Medicine and Primary Health Care Protestant University of Congo Kinshasa Democratic Republic of Congo Faculty of Medicine University of Joseph Kasavubu Boma Democratic Republic of Congo Department of Health Sciences National Pedagogical University Kinshasa Democratic Republic of Congo Department of Cardiology University of Kinshasa Kinshasa Democratic Republic of Congo

Background and Objective: Despite the costs generated in the diagnosis of cardiac pathologies by the use of ultrasound, the ECG indices have demonstrated a high performance in the studies of developed countries in the diagnosis of these pathologies, but the data of these in sub-Saharan Africa are limited. The objective of this study is to evaluate the performance of the Peguero-Lo Presti index in the diagnosis of LVH among Congolese in order to make it a means of LVH diagnosis in an under-equipped environment. Methods: Cross-sectional and analytical study including 413 patients followed and hospitalized at the CIMAK Hospital Center during the period from February 2019 to June 2021. Sociodemographic parameters, history, biology, ultrasound and ECG parameters were studied. The performance of the Peguero-Lo Presti Index was validated by the Youden Index reinforced by the Area under the ROC curve. Results: Of the 413 patients admitted to the study, 69.5% were men versus 30.5% women, i.e. a sex ratio of 2M/1F;the mean age of the patients was 51.1 ± 11.6 years. The frequency of LVH found by echocardiography was 55.9%, it was 50.8% using the Peguero-Lo Presti index, 22% and 10.2% using the Peguero-Lo Presti index, respectively. Sokolow-Lyon and Cornell (p 0.001). The Peguero-Lo Presti curve is higher than the Sokolow-Lyon and Cornell curves. The area under the curve was 0.80 for Peguero-Lo Presti, 0.73 for Sokolow-Lyon and 0.66 for cornell. Conclusion: The newly proposed Peguero-Lo Presti index provides high sensitivity and specificity for the diagnosis of LVH in black Africans as also reported in the European and American population.

关键词： Performance Peguero-Lo Presti ECG Sokolow-Lyon Cornell DRC

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Left Ventricular Measurements in Black Sub-Saharan Africans and White Maghreb

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World Journal of Cardiovascular Diseases 2017年第6期7卷 195-206页

作者： bernard phanzu kianu Charifa Annis Sidibe Moussa Eleuthère Vita Kintoki Karimi El Saloua Dounia Benzaroual Mustapha El Hattaoui Benjamin Longo-Mbenza Jena-Réné M’buyamba Kabangu Cardiology Unit University Hospital of Kinshasa University of Kinshasa Kinshasa Congo Cardiology Unit CHU Mohammed VI Cady Ayyad University Marrakech Morocco Faculty of Health Sciences Walter Sisulu University Mthatha South Africa

Background: Evidence that blacks have greater left ventricular mass (LVM) than whites has been demonstrated by large population-based American studies. However, to our knowledge, there is no study to date comparing LVM in Black Sub-Saharan Africans (BSSA) and the Maghreb white population. We compared LVM measured echocardiographically in asymptomatic BSSA and Maghreb. Methods and Results: A total of 100 asymptomatic BSSA and 189 Maghreb, (18 to 55 years old), underwent resting two-dimensional transthoracic echocardiography. LVM and geometry were assessed according to the 2015 American Society of Echocardiography and the European Association of Cardiovascular Imaging updated guidelines for cardiac chamber quantification. Crude or indexed LVM to body surface area or height2.7 was similar in BSSA and in Maghreb (132.7 ± 37.0 vs. 134.2 ± 35.7 g;73.1 ± 17.8 vs. 72.9 ± 16.2 g/m2;32.1 ± 9.8 vs. 33.6 ± 9.5 g/m2.7). However, the left ventricular posterior wall was thicker in BSSA. Patterns of left ventricular geometry (normal, concentric remodeling, or concentric or eccentric hypertrophy) were equally distributed among the two ethnic groups. Conclusions: Left ventricular posterior wall thickness but not LVM is greater in BSSA than in Maghreb.

关键词： Left Ventricular Mass Ethnicity White Maghreb Black Sub-Saharan Africa

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Influence of Diet Behavior on Insulin Resistance in Hypertensive Black Sub-Saharan Africans: A Multicentric, Cross-Sectional Study

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World Journal of Cardiovascular Diseases 2020年第9期10卷 615-638页

作者： kianu phanzu bernard Nkodila Natuhoyila Aliocha Kokusa Zamani Roger Limbole Baliko Emmanuel Kintoki Vita Eleuthère M’buyamba Kabangu Jean-Réné Longo-Mbenza Benjamin Unit of Cardiology University Hospital of Kinshasa Kinshasa Democratic Republic of Congo Centre Médical de Kinshasa (CMK) Kinshasa Democratic Republic of Congo Public Health School Department of Biostatistics Kinshasa Democratic Republic of Congo Provincial Reference Hospital of Kinshasa Kinshasa Democratic Republic of Congo Clinique Ngaliema Kinshasa Democratic Republic of Congo

Background: Insulin resistance (IR) is the backbone of cardiovascular diseases (CVDs). The latter are the most common non-communicable diseases globally. Diet is an important determinant of CVDs. The link between diet and cardiovascular health could be explained by an association between diet pattern and IR. Aims: To investigate the association between salt and specific food consumption as well as different diet patterns (Mediterranean, westernized, and intermediate dietary patterns) with HOMAIR as a surrogate marker of IR, and fasting insulin in Black, sub-Saharan essential hypertensive patients. Methods: The multicentric, cross-sectional analysis involved 77 Congolese Black hypertensive participants with no history of cardiovascular disease. Daily sodium chloride intake (NaCl g/24h) was estimated from 24-hour urine collection. Dietary behaviours were evaluated through a semi-quantitative food frequency questionnaire (FFQ). Homeostatic model assessment of insulin resistance (HOMAIR) ≥ 2.5 was used as surrogate marker of IR. Results: A decrease in weekly consumption of fruits, vegetables and fish would significantly explain an increase of 29% (r = 0.292;p = 0.010), 24% (r = 0.242;p = 0.034) and 23% (r = 0.226;p = 0.048) of the value of HOMAIR respectively. In contrast, an increase in daily sodium chloride intake was associated with 28% (r = 0.283, p = 0.027) of the increase in HOMAIR. Also, a decrease in the average weekly consumption of fruit, vegetables and fish would significantly explain an increase of 25% (r = 0.247;p = 0.030), 30% (r = 0.302;p = 0.008) and 31% (r = 0.313;p = 0.006) of fasting insulin. In contrast, an increase in red meat consumption was associated with a 26% increase (r = 0.257, p = 0.024) in fasting insulin. In multivariable adjusted analysis 45% of variation in fasting insulin (R2 = 0.452;overall p = 0.005) were explained by fruits, vegetables and fish consumption. 38% of variat

关键词： Diet Behavior Insulin Resistance Hypertension Black Sub-Saharan Africans

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