Cardiometabolic diseases and associated risk factors in transitional rural communities in tropical coastal Ecuador

by Monsermin Gualan, Irina Chis Ster, Tatiana Veloz, Emily Granadillo, Luz M. Llangari-Arizo, Alejandro Rodriguez, Julia A. Critchley, Peter Whincup, Miguel Martin, Natalia Romero-Sandoval, Philip J. Cooper

There is a growing epidemic of chronic non-communicable diseases in low and middle-income countries, often attributed to urbanization, although there are limited data from marginalized rural populations. This study aimed to estimate prevalence of cardiometabolic diseases and associated risk factors in transitional rural communities.

A cross-sectional study of Montubio adults aged 18–94 years living in agricultural communities in a tropical coastal region of Ecuador. Data were collected by questionnaires and anthropometry, and fasting blood was analyzed for glucose, glycosylated hemoglobin, insulin, and lipid profiles. Population-weighted prevalences of diabetes, hypertension, and metabolic syndrome were estimated. Associations between potential risk factors and outcomes were estimated using multilevel regression techniques adjusted for age and sex.

Out of 1,010 adults recruited, 931 were included in the analysis. Weighted prevalences were estimated for diabetes (20.4%, 95% CI 18.3–22.5%), hypertension (35.6%, 95% CI 29.0–42.1%), and metabolic syndrome (54.2%. 95% CI 47.0–61.5%) with higher prevalence observed in women. Hypertension prevalence increased with age while diabetes and metabolic syndrome peaked in the 6^th and 7^th decades of life, declining thereafter. Adiposity indicators were associated with diabetes, hypertension, and metabolic syndrome.

We observed an unexpectedly high prevalence of diabetes, hypertension, and metabolic syndrome in these marginalized agricultural communities. Transitional rural communities are increasingly vulnerable to the development of cardiometabolic risk factors and diseases. There is a need for targeted primary health strategies to reduce the burden of premature disability and death in these communities.