Socioeconomic inequalities in metabolic syndrome in the French West Indies.

BACKGROUND: Obesity and metabolic diseases represent a major health burden in the Caribbean, particularly since a large part of the population is disadvantaged. However, socioeconomic inequalities in chronic diseases are poorly explored in this region. We investigated the association between socioeconomic position and metabolic syndrome (MetS) prevalence and explored the contribution of diet quality to explain this association, among adults in the French West Indies. METHODS: This cross-sectional analysis included 1144 subjects (≥16 y) from a multistage sampling survey conducted in 2013-2014 on a representative sample of the Guadeloupean and Martinican population. MetS prevalence was assessed using the Joint Interim Statement. Dietary intakes were estimated from 24 h-dietary recalls, and diet quality was assessed through the Diet Quality Index-International (DQI-I). Associations between socioeconomic indicators (education, employment, social assistance benefits) and MetS prevalence, and the potential contribution of diet quality in this association were assessed using multivariable logistic regression models, adjusted for sociodemographic characteristics. RESULTS: MetS prevalence adjusted for age and sex was 21 and 30% among Guadeloupean and Martinican, respectively. Compared to high-educated participants, low-educated subjects were more likely to be at risk of MetS (OR = 2.4; 95%CI = [1.3-4.4], respectively), as were recipients of social assistance benefits compared to non-recipients (OR = 2.0; 95%CI = [1.0-4.0]). The DQI-I explained 10.5% of the overall variation in MetS due to education. CONCLUSIONS: Socioeconomic inequalities in MetS prevalence, reflected by education and social assistance benefits, were found. However, diet quality contributed only to socioeconomic inequalities due to education underlining that education may impact health through the ability to generate overall dietary behavior, long-term beneficial. Our work identified subgroups with higher risk of MetS, which is needed when implementing public health measures, particularly in this Caribbean population with of high poverty rates. Further prospective studies are needed to improve our understanding of the mechanisms of social inequalities in MetS in a high poverty rates context.

The prevalence of ESRD treated with renal dialysis in France in 2003.

BACKGROUND: The prevalence of end-stage renal disease (ESRD) treated with renal dialysis is poorly known in France because there is no national registry of dialysis patients. The specific aims of this study are to determine the total number of patients treated with renal dialysis and their social, demographic, and clinical characteristics, as well as define the overall care they received. METHODS: We performed a cross-sectional descriptive study from June 2 to June 8, 2003, in all renal dialysis units (including pediatric units) by including all patients residing in France with ESRD who were dialyzed during that week, irrespective of age or the treatment they received. We gathered sociodemographic (age, sex, place of residence, and occupation) and clinical data (year they entered dialysis therapy, initial renal disease, comorbidities, and associated handicaps) and information concerning their overall treatment plan (waiting list for kidney transplant, therapeutic regimen, and dialysis technique used). RESULTS: A total of 30,882 patients residing in France were treated with renal dialysis. The unadjusted prevalence of dialysis was 513.1 patients per million population (pmp); 498.2 pmp in metropolitan France and 1,035.7 pmp in the overseas territories. Clinical and sociodemographic characteristics of patients and their therapeutic regimens were different in metropolitan France and the overseas territories. CONCLUSION: This study constitutes the first comprehensive inventory of dialysis therapy in France, where the prevalence of ESRD is among the highest in the world.