Thesis defended with a view to obtaining the Grade of Agrégé of Higher Education in Medicine

By

Danny MAFUTA MUNGANGA Doctor of Medicine Specialist in Internal Medicine

Promoter : Professor Dr. Benjamin LONGO MBENZA

Co-Promoter: Professor Dr Jean Bosco KASIAM LASI ON'KIN

FEBRUARY 2023

SUMMARY

CONTEXT AND OBJECTIVE

Obesity constitutes a major public health problem and is associated with insulin resistance (IR), cardiovascular diseases (CVD), metabolic syndrome (MetS), cancers and respiratory diseases.
traditional anthropometric parameters including waist circumference (WC),
have proven their limitations in the assessment of cardiometabolic risk (RCM). Several studies conducted in Caucasian, Asian and Latin populations have proposed the measurement of neck circumference (CC) as an alternative to TT. No study, to our knowledge, in sub-Saharan Africa (SAA), has been conducted on this subject. The present research aimed to evaluate the relationship between CC, IR and RCM in the Bantus of Kinshasa and Brazzaville.

METHODS

Two population-based, cross-sectional, and analytical studies were conducted in the city of Brazzaville, Republic of Congo, from February to May 2019. The first consisted not only of determining CC thresholds for the detection of abdominal obesity, but also of establishing the association between CC and traditional anthropometric parameters of abdominal obesity on the one hand, and visceral adiposity indices on the other. The second established the relationship between CC and indicators of IR. However, a third single-center, cross-sectional, analytical study included RCM patients followed er outpatient clinic at the Lomo Médical Clinic in Kinshasa from January to September 2019. It established the association between CC and traditional cardiometabolic risk factors (CMRF).

RESULTS

Among Congolese Santu in Brazzaville and Kinshasa, increased CC is associated with RI. CC is associated with abdominal obesity and positively correlated with visceral adiposity indices. The cutoff values of 38 cm and 33 cm, in men and women, respectively, identify abdominal obesity and RI. CC is also more effective than TT in predicting RI and in assessing RCM.

CONCLUSION

CC measurement is a simple, easy-to-reproduce, and inexpensive tool that can identify individuals with CMR among Congolese Santu, particularly in Brazzaville and Kinshasa. Insulin resistance is strongly associated with CC.
Keywords: Neck circumference, Brazzaville, Kinshasa, Santu, local thresholds, insulin resistance, cardiometabolic risk, visceral adiposity