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Metabolic syndrome in sub-Saharan Africa: “smaller twin” of a region’s prostatic diseases?


Prostate cancer (PC) and benign prostate hyperplasia (BPH) constitute many of the health concerns of males around the world. Prostate cancer is the major cause of death after lung cancer in men. Benign prostate hyperplasia affects most males above 40 years of age. A variety of factors, chiefly age, genetics and lifestyle, have been linked to the development of PC and BPH. The metabolic syndrome describes a chain of chronic disorders that are inter-related in aetiology, and result from unhealthy lifestyles, often due to an affluent economy. The eating of processed foods and a sedentary lifestyle apparently are status symbols among the middle and upper classes in sub-Saharan Africa. These have resulted in a surge in the disease burden of sub-Saharan Africa. This paper looks at the aetiology and prevalence of the metabolic syndrome and prostatic diseases, especially in sub-Saharan Africa. Evidence from the available literature shows that prostate disorders may be related to the metabolic syndrome. There is a likelihood that if sub-Saharan Africans keep copying the lifestyles of the developed world, especially in the direction of the nature of food items consumed, then the rising prevalence of diseases of the metabolic syndrome and the attendant prostate disorders may become very formidable healthcare “twin” problems for the region.

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  1. 1.

    Landis SH, Murray T, Bolden S (1999) Cancer statistics 1999. Cancer J Clin 49:8–13

  2. 2.

    Kumar RJ, Bargawi AIB, Crawford DE (2004) Epidemiology of prostate cancer. Business briefing, US oncology review, pp 1–6

  3. 3.

    Parkin OM, Bray FI, Devesa SS (2001) Cancer burden in the year 2000: the global picture. Eur J Cancer 37(8):54–66

  4. 4.

    Haas GP, Sakr WA (1997) Epidemiology of prostate cancer. Cancer J Clin 47:273–287

  5. 5.

    Greenlee RT, Murray T, Bolden S, Wingo PA (2000) Cancer statistics 2000. Cancer J Clin 50:7–33

  6. 6.

    Taplin ME, Ho S-M (2001) The endocrinology of prostate cancer. J Clin Endocrinol Metab 86(8):3467–3477

  7. 7.

    American Cancer Society (2004) Cancer facts and figures. American Cancer Society

  8. 8.

    Quinn M, Babb P (2002) Patterns and trends in prostate cancer incidence, survival, prevalence and mortality. I. International comparisons. BJU Int 90(2):162–173

  9. 9.

    Clegg LX, Li FP, Hankey BF, Chu K, Edwards BK (2002) Cancer survival among US whites and minorities: a SEER (Surveillance, Epidemiology and End Result) programme population-based study. Arch Intern Med 162(17):1985–1993

  10. 10.

    Parker SI, Tong T, Bolden S et al (1997) Cancer statistics 1997. Cancer J Clin 47:5–27

  11. 11.

    Ejike CECC (2006) Prostate disorders in Nsukka, in relation to some biochemical parameters. Dissertation, Department of Biochemistry, University of Nigeria

  12. 12.

    Shibata K, Hirasawa A, Morinyma N (1996) Alpha 1a-adrenoceptor polymorphism: pharmacological characterisation and association with benign prostatic hypertrophy. Br J Pharmacol 118:140–148

  13. 13.

    Garraway WM, Collins GN, Lee RJ (1991) High prevalence of benign prostate hypertrophy in the community. Lancet 24:469–471

  14. 14.

    Chicharro-Molero JA, Burgos-Rodriguez R, Sanchez-Cruz JJ, del Rosal-Samaniego JM, Rodero-Carcia P, Rodriguez-Vallejo JM (1998) Prevalence of benign prostatic hyperplasia in Spanish men 40 years old or older. J Urol 159(3):878–882

  15. 15.

    Park YH, Chung MK (2001) The prevalence of clinical BPH and LUTS in South-East Korea: a community-based study. J Pusan Natl Univ Hosp 9:141–157

  16. 16.

    Verhamme KM, Dieleman JP, Bleumink GS et al (2002) Incidence and prevalence of lower urinary tract symptoms suggestive of benign prostate hyperplasia in primary care—the TRIUMPH project. Eur Urol 42:323–328

  17. 17.

    Ezeanyika LUS, Ejike CECC, Obidoa O, Elom SO (2006) Prostate disorders in an apparently normal Nigerian population. I. Prevalence. Biokemistri 18(2):127–132

  18. 18.

    Mehik A, Hellstrom P, Sarpola A, Lukkarinen O, Jarvelin MR (2000) Epidemiology of prostatitis in Finnish men: a population-based cross-sectional study in Finland. BJU Int 86:443–448

  19. 19.

    Nickel JC, Downey J, Hunter D, Clark J (2001) Prevalence of prostatitis-like symptoms in a population-based study, using the National Institutes of Health chronic prostatitis symptom index. J Urol 165(3):842–845

  20. 20.

    Rizzo M, Marchelti F, Travaglini F, Trinchieri A, Nickel JC (2003) Prevalence, diagnosis and treatment of prostatitis in Italy: a prospective urology outpatient practice study. BJU Int 92(9):955–959

  21. 21.

    Rosebud RO, Debra JJ, Girman CJ, Rhodis T, Leiber MM, Steven JJ (2002) Prevalence of prostatitis-like symptoms in a community based cohort of older men. J Urol 168(6):2467–2471

  22. 22.

    Tan JK, Prg DJ, Liew LC, Li MK, Wong ML (2002) Prevalence of prostatitis-like symptoms in Singapore: a population-based study. Singapore Med J 43(4):189–193

  23. 23.

    Domingue JGA Sr, Hellstrom YJG (1998) Prostatitis. Clin Microbiol Rev 11(4):604–613

  24. 24.

    Naber KG, Weidner W (2000) Chronic prostatitis—an infectious disease? J Antimicrob Chemother 46:157–161

  25. 25.

    Kirby RS, Lowe D, Bultitud I, Shuttleworth KED (1982) Intra prostatic urinary reflux: an aetiological factor in abacterial prostatitis. BJU Int 54:729–731

  26. 26.

    Chapple CR, Blease SCF, Rickards D (1990) What is the clinical significance of urethoprostatic reflux as a radiological finding during videocystourethography in neurologically normal patients? Eur Urol 17:296–298

  27. 27.

    Barbalias GA, Meares EM Jr, Sant GR (1983) Prostatodynia: clinical and urodynamic characteristics. J Urol 130(3):514–517

  28. 28.

    Barbalias GA (1990) Prostatodynia or painful male urethral syndrome? Urology 36(2):146–153

  29. 29.

    Doble A, Walker MM, Hannis JRW, Taylor-Robinson D, Whiterow RO, Grave N (1990) Intraprostatic antibody deposition in chronic abacterial prostatitis. BJU Int 65:598–605

  30. 30.

    Nishimura T, Abe H, Ikeda K, Oka F, Yamamoto M (1998) IL-1ra versus IL-1 levels in prostatic fluid from prostatitis patients. Urol Int 60:92–96

  31. 31.

    Berghius JP, Heiman JR, Rothman I, Berger RE (1996) Psychological and physiological factors involved in chronic prostatitis. J Psychosom Res 41(4):313–325

  32. 32.

    Mehik A, Hellstrom P, Sarpola A, Lukkarinen O, Jarvelin MR (2001) Fears, sexual disturbances and personality features in men with prostatitis: a population-based cross-sectional study in Finland. BJU Int 88:35–38

  33. 33.

    Eaton CL (2003) Aetiology and pathogenesis of benign prostatic hyperplasia. Curr Opin Urol 13:7–10

  34. 34.

    Berry SJ, Coffey DS, Walsh PC, Ewing LL (1984) The development of human BPH with age. J Urol 132:474–479

  35. 35.

    Pienta KJ, Esper PS (1993) Risk factors for prostate cancer. Ann Intern Med 118:793–803

  36. 36.

    Steinberg GD, Carter BS, Beaty TH, Childs B, Walsh PC (1990) Family history and risk of prostate cancer. Prostate 17:337–347

  37. 37.

    Gronberg H, Damber L, Damber JE (1996) Familial prostate cancer in Sweden: a nationwide register cohort study. Cancer 77:138–143

  38. 38.

    Baquet CR, Horm JW, Gibbs T, Greenwald P (1991) Socio-economic factor and cancer incidence among blacks and whites. J Natl Cancer Inst 83:551–557

  39. 39.

    Borring CC, Squires TS, Heath CW Jr (1992) Cancer statistics for African-Americans. Cancer J Clin 42:7–17

  40. 40.

    Jackson MA, Ahluwalia BS, Herson J et al (1977) Characterization of prostatic carcinoma among blacks: a continuation report. Cancer Treat Rep 61:167–172

  41. 41.

    Neuhausen SL, Farnhan JM, Kort E, Tavtigian SV, Skolnick MH, Cannon-Albright LA (1999) Prostate cancer susceptibility locus HPC1 in Utah high-risk pedigrees. Hum Mol Genet 8:2437–2442

  42. 42.

    Gibbs M, Chakrabarti L, Stanford JL et al (1999) Analysis of chromosome 1q42.2–43 in 152 families with high risk of prostate cancer. Am J Hum Genet 64:1087–1095

  43. 43.

    Lange EM, Chen H, Brierly K, Perrone EE, Bock CH, Gillanders E, Ray ME, Cooney KA (1999) Linkage analysis of 153 prostate cancer families over a 30-cM region containing the putative susceptibility locus HPCX. Clin Cancer Res 5:4013–4020

  44. 44.

    Gibbs M, Stamford JL, McIndoe RA et al (1999) Evidence for rare prostate cancer-susceptibility locus at chromosome 1p36. Am J Hum Genet 64:776–787

  45. 45.

    Tavtigian SV, Simard J, Labrie F, Skolnick MH, Neuhausen SL, Rommeus J, Cannon-Albright LA (2000) A strong candidate prostate cancer predisposition gene at chromosome 17p. Am J Hum Genet 67 [Suppl]:11

  46. 46.

    Rebbeck TR, Walker AH, Zeigler-Johnson C, Weisburg S, Martin M, Nathanson KL, Wein AJ, Malkowicz SB (2000) Association of HPC2/ELAC2 genotypes and prostate cancer. Am J Hum Genet 67:1014–1019

  47. 47.

    Cerhan JR, Parker AS, Putman SD, Chui BC, Lynch CF, Cohen MB, Torner JC, Cantor KP (1999) Family history and prostate cancer risk in a population-based cohort of Iowa men. Cancer Epidemiol Biomarkers Prev 8:53–60

  48. 48.

    Wang Q, Zhang H, Fishel R, Greene HI (2000) BRAC1 and cell signalling. Oncogene 19:6152–6158

  49. 49.

    Mononen N, Syrajakoski K, Matikainen M, Schleukler J, Tammela TLJ, Koivisto PA, Kallioniemi OP, Trapman J (2000) Two percent of Finnish cancer patients have a germ-line mutation in the hormone-binding domain of the androgen receptor gene. Cancer Res 60:6479–6481

  50. 50.

    Makridakis N, Ross RK, Pike MC et al (1997) A prevalent missense substitution that modulates activity of prostatic steroid 5α-reductase. Cancer Res 57:1020–1022

  51. 51.

    Lunn RM, Bell DA, Mohler JL, Taylor JA (1999) Prostate cancer risk and polymorphism in 17 hydroxylase (CYP17) and steroid reductase (SRD5A2). Carcinogenesis 20:1727–1731

  52. 52.

    Devgan SA, Henderson BE, Yu MC, Shi CY, Pike MC, Ross RK, Reichardt JKV (1997) Genetic variation of 3β-Hydroxysteroid dehydrogenase type II in three racial/ethnic groups: implications for prostate cancer risk. Prostate 33:9–12

  53. 53.

    Lin X, Tascilar M, Lee WH et al (2001) GSTP1 CpG island hypermethylation is responsible for the absence of GSTP1 expression in human prostate cancer cells. Am J Pathol 159:1815–1826

  54. 54.

    Ornstein DK, Cinquanter M, Weiler S, Duray PH, Emmert-Buck MR, Vocke CD, Linehan WM, Ferretti JA (2001) Expression studies and mutational analysis of the androgen regulated homeobox gene NKX3.1 in benign and malignant prostate epithelium. J Urol 165:1329–1334

  55. 55.

    Xu J, Zheng SL, Komiya A et al (2002) Germline mutations and sequence variants of the macrophage scavenger receptor 1 gene are associated with prostate cancer risk. Nat Genet 32:321–325

  56. 56.

    Ross R, Bernstein L, Judd H Hanisch R, Pike M, Henderson B (1986) Serum testosterone levels in healthy young black and white men. J Natl Cancer Inst 76:45–48

  57. 57.

    Ellis L, Nyborg H (1992) Racial/ethnic variations in male testosterone levels: a probable contributor to group differences in health. Steroids 57:72–75

  58. 58.

    Litman JH, Bhasi S, Link CL, Araujo AB, McKinlay JB (2006) The Boston area community health survey investigators. Serum androgen levels in black, Hispanic and white men. J Clin Endocrinol Metab 91:4326–4334

  59. 59.

    Heber D (2002) Prostate enlargement: the canary in the coal mine? Am J Clin Nutr 75:605–606

  60. 60.

    Tsugane S, Gotlieb SL, Laurenti R, de Souza JM, Watanabe S (1990) Cancer mortality among Japanese residents in the city of São Paulo Brazil. Int J Cancer 45:436–439

  61. 61.

    Shimizu H, Ross RK, Bernstein L, Yatani R, Henderson BE, Mack TM (1991) Cancers of the prostate and breast among Japanese and white immigrants in Los Angeles county. Br J Cancer 63:963–966

  62. 62.

    Bosland MC, Dreef van der Meulen HC, Schereenberg PM (1990) Effect of dietary fat on rat prostate carcinogenesis induced by N-methyl-N-nitrosurea and testosterone [abstract]. Proc Am Assoc Cancer Res 31:144

  63. 63.

    Armstrong B, Doll R (1975) Environmental factors and cancer incidence and mortality in different countries, with specific reference to dietary patterns. Int J Cancer 15:617–631

  64. 64.

    Whittemore AS, Kolonel LN, Wu AH et al (1995) Prostate cancer in relation to diet, physical activity and body size in blacks, whites and Asians in the United States and Canada. J Natl Cancer Inst 87(9):652–661

  65. 65.

    Kolonel L (1996) Nutrition and prostate cancer. Cancer Causes Control 7:83–94

  66. 66.

    Veirod MB, Laake P, Thelle OS (1997) Dietary fat intake and risk of prostate cancer: a prospective study of 25,708 Norwegian men. Int J Cancer 73(5):634–638

  67. 67.

    Giles G, Ireland P (1997) Diet nutrition and prostate cancer. Int J Cancer 10:13–17

  68. 68.

    Ho PJ, Baxter RC (1997) Insulin-like growth factor binding protein-2 in patients with prostate carcinoma and benign prostate hyperplasia. Clin Endocrinol (Oxf) 46(3):333–342

  69. 69.

    Bosland MC (2000) The role of steroid hormones in prostate carcinogenesis. J Natl Cancer Inst (Monogr) 27:39–66

  70. 70.

    Dagnelie PC, Schurman AG, Goldbohm RA, van der Brandt PA (2004) Diet, anthropometric measures and prostate cancer risk: a review of prospective cohort intervention studies. BJU Int 93(8):1139–1150

  71. 71.

    Hammarsten J, Hogstedt B (1999) Clinical, anthropometric, metabolic and insulin profile in men with fast annual growth rates of BPH. Blood Press 8(1):29–36

  72. 72.

    Suzuki S, Platz EA, Kawachi I, Willett WC, Giovannucci E (2002) Intake of energy and macronutrients and the risk of benign prostatic hyperplasia. Am J Clin Nutr 75(4):689–697

  73. 73.

    Kaklamani VG, Linos A, Kaklamani E, Markaki I, Koumantaki Y, Mantzoros CS (1999) Dietary fat and carbohydrates are independently associated with circulating IGF-1 and IGFBP-3 concentration in healthy adults. J Clin Oncol 17:3291–3299

  74. 74.

    Dunn SE, Kari FW, French J et al (1997) Dietary restriction regulates IGF-1 levels which modulates apoptosis, cell proliferation and tumour progression in p53-deficient mice. Cancer Res 57:4667–4672

  75. 75.

    Stattin P, Rinaldi S, Biessy C, Stenmen UH, Hallmans G, Kaaks R (2004) High levels of circulating insulin-like growth factor-1 increase prostate cancer risk: a prospective study in a population-based nonscreened cohort. J Clin Oncol 22:3104–3112

  76. 76.

    Chan JM, Stampter MJ, Giovannucci E et al (1998) Plasma insulin like growth factor-1 and prostate cancer risk: a prospective study. Science 279(5350):563–566

  77. 77.

    Heber D, Bowerman S (2001) What color is your diet? Regan/Harper, New York

  78. 78.

    Heinonen OP, Albanes D, Virtamo J et al (1998) Prostate cancer and supplementation with alpha-tocopherol and beta-carotene: incidence and mortality in a controlled trial. J Natl Cancer Inst 90:440–446

  79. 79.

    Peehl DM (1999) Vitamin D and prostate cancer risk. Eur Urol 35:392–394

  80. 80.

    Hanchette CI, Schwartz GG (1992) Geographic patterns of prostate cancer mortality: evidence for a protective effect of ultraviolet radiation. Cancer 70:2861–2869

  81. 81.

    Clark L, Dalkin B, Kronrad A, Combs G, Turnbull B (1998) Decreased risk of prostate cancer with selenium supplementation: results of a double blind cancer prevention study. BJU Int 81:730–734

  82. 82.

    Adlercreutz H, Markkanen H, Watanabe S (1993) Plasma concentrations of phyto-oestrogens in Japanese men. Lancet 342:1209–1210

  83. 83.

    Shirai T, Asamoto M, Takahashi S, Imaida K (2002) Diet and prostate cancer. Toxicology 18:181–182

  84. 84.

    Wertz K, Silver U, Goralczyk R (2004) Lycopene: modes of action to promote prostate health. Arch Biochem Biophys 430(1):127–134

  85. 85.

    Pentyala SN, Lee J, Hsieh K, Waltzer WC, Trocchia A, Musacchia L, Rebecchi MJ, Khan SA (2000) Prostate cancer: a comprehensive review. Med Oncol 17:85–105

  86. 86.

    Elghany NA, Schumacher MC, Slattery ML, West DW, Lee JS (1990) Occupation, cadmium exposure, and prostate cancer. Epidemiology 1:107–115

  87. 87.

    Matzkin H, Soloway MS (1993) Cigarette smoking: a review of possible association with benign prostatic hyperplasia and prostate cancer. Prostate 22:277–290

  88. 88.

    Oishi K, Okada K, Yoshida O et al (1990) A case control study of prostatic cancer in Tokyo, Japan: sexual risk factors. Prostate 17:269–279

  89. 89.

    Kenge PA, Amoah AGB, Mbanya JC (2005) Cardiovascular complications of diabetes mellitus in sub-Saharan Africa. Circulation 112:3592–3601

  90. 90.

    Yach D, Hawlees C, Grould CL, Hofman KJ (2004) The global burden of chronic diseases: overcoming impediments to prevention and control. JAMA 291:2616–2622

  91. 91.

    Grundy SM, Brewer HB Jr, Cleeman JI, Smith ST Jr, Lentant C (2004) Definition of metabolic syndrome: report of the National Heart, Lung and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 109:433–438

  92. 92.

    Furukawa S, Fujuta T, Shimabukuro M et al (2004) Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest 114:1752–1761

  93. 93.

    Nelson WG, DeMarzo AM, Issacs WB (2003) Prostate cancer. N Engl J Med 349:366–381

  94. 94.

    Khandawala HM, McCutcheon IE, Flybierg A, Friend KT (2000) The effects of IGF on tumorigenesis and neoplastic growth. Endocr Rev 21:215–244

  95. 95.

    Wang W, Bergh A, Damber JE (2004) Chronic inflammation in BPH is associated with focal upregulation of cyclo-oxygenase-2, Bd-2 and cell proliferation in glandular epithelium. Prostate 61:60–72

  96. 96.

    Haffner S, Taegtmeger H (2003) Epidemic obesity and the metabolic syndrome. Circulation 108:1541–1545

  97. 97.

    Reaven GM, Lithell A, Landsberg L (1996) Hypertension and associated metabolic abnormalities: the role of insulin resistance and sympathetic adrenal system. N Engl J Med 334:374–381

  98. 98.

    Hunter SJ, Garvey T (1998) Insulin action and insulin resistance: involving defects in insulin receptor, signal transduction and glucose transport effector system. Am J Med 5:331–346

  99. 99.

    Sowers JR (1996) Effects of insulin and IGF-1 on vascular smooth muscle glucose and cation metabolism. Diabetes 45(3):S47–S51

  100. 100.

    Sowers JR (1997) Insulin and insulin-like growth factor in normal and pathological cardiovascular physiology. Hypertension 29:691–699

  101. 101.

    McFarlane SI, Banerji M, Sowers JR (2001) Insulin resistance and cardiovascular disease. J Clin Endocrinol Metab 86(2):713–718

  102. 102.

    Holly J (1998) Insulin-like growth factor and new opportunities for cancer prevention. Lancet 351:1373–1374

  103. 103.

    Khosravi J, Diamandi A, Mistry J, Scorilas A (2001) Insulin-like growth factor 1 (IGF-1) and IGF binding protein 3 in benign prostatic hyperplasia and prostate cancer. J Clin Endocrinol Metab 86(2):694–699

  104. 104.

    Kolterman OF, Insel J, Sackow M, Olefsky M (1980) Mechanism of insulin resistance in human obesity: evidence for receptor and postreceptor defects. J Clin Invest 65(6):838–844

  105. 105.

    WHO (1995) Physical status: the use and interpretation of anthropometry: report of a WHO expert committee. WHO Tech Rep Ser 854:1–452

  106. 106.

    Flegal KM, Caroll MD, Kuczmarski RJ, Johnsom CL (1998) Overweight and obesity in the US: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord 22(1):39–47

  107. 107.

    Levitt NS, Lambert EV (2002) The foetal origins of the metabolic syndrome: a South African perspective. Cardiovasc J S Afr 13:179–180

  108. 108.

    Vorster HH, Bourne LT, Venter CS, Oosthluzen W (1999) Contribution of nutrition to the health transition in developing countries: a framework for research and intervention. Nutr Res 57:341–349

  109. 109.

    Caballero B (2005) A nutrition paradox—underweight and obesity in less developed countries. N Engl J Med 352(15):1514–1516

  110. 110.

    WHO (2005) WHO global infobase online. Accessed 20 Oct 2005

  111. 111.

    Daniel HW (1993) Larger prostatic adenomas in obese men with no associated increase in obstructive uropathy. J Urol 149(2):315–317

  112. 112.

    Giovannucci E, Rimm EB, Chute CG, Kawachi I, Golditz GA, Stamer MI, Willet WC (1994) Obesity and benign prostate hyperplasia. Am J Epidemiol 140(11):989–1002

  113. 113.

    Soygür T, Küpeli B, Aydos K, Küpeli S, Arikan N, Müftüğlu YZ (1996) Effect of obesity in prostate hyperplasia: its relation to sex steroids. Int Urol Nephrol 28(1):55–59

  114. 114.

    Calle EE, Rodriguez C, Walker-Thurmond K, Then MJ (2003) Overweight, obesity and the mortality from cancer in a prospectively studied cohort of US adults. N Engl J Med 348(17):1625–1638

  115. 115.

    Lee S, Min GH, Choi SH, Kin YJ, Oh SW, Kims YJ, Park Y, Kin SS (2006) Central obesity as a risk factor for prostatic hyperplasia. Obesity 14:172–179

  116. 116.

    Parsons JK, Carter BH, Partin AW, Windham BG, Metter FJ, Ferucci LI, Landis P, Platz EA (2006) Metabolic factors associated with BPH. J Clin Endocrinol Metab 91(7):2562–2568

  117. 117.

    Atkinson MA, Maclaren NK (1994) The pathogenesis of insulin dependent diabetes mellitus. N Engl J Med 331:1428–1436

  118. 118.

    Kahn BB, Flier JS (2000) Obesity and insulin resistance. J Clin Invest 106:473–481

  119. 119.

    King H, Auber RE, Herman WH (1998) Global burden of diabetes, 1995–2025: prevalence, numerical estimates and projections. Diabetes Care 21:1414–1431

  120. 120.

    Sobngwi E, Mauvis-Javis F, Vexiau P, Mbanya JC, Gantier JF (2001) Diabetes in Africa. I. Epidemiology and clinical specificities. Diabetes Metab 27:628–634

  121. 121.

    Motala AA, Omar MA, Pirie FJ (2003) Diabetes in Africa: epidemiology of Type 1 and Type 2 diabetes in Africa. J Cardiovasc Risk 10:77–83

  122. 122.

    Swai AB, McLarty DG, Kitange HM, Kilma PM, Tatalla S, Keen N, Chuwa LM, Alberti KG (1993) Low prevalence of risk factors for coronary heart disease in rural Tanzania. Int J Epidemiol 22:651–659

  123. 123.

    Van der Sande MA, Milligan PJ, Nyan OA et al (2000) Blood pressure patterns and cardiovascular risk factors in rural and urban Gambian communities. J Hum Hypertens 14:489–496

  124. 124.

    Puoane T, Steyn K, Bradshaw D, Laubscher R, Fourie J, Lamber V, Mbanaga N (2002) Obesity in South Africa: the South African demographic and health survey. Obes Res 10:1038–1048

  125. 125.

    Mbanya JCN, Minkonlou EM, Salah JN, Balkau B (1998) The prevalence of hypertension in rural and urban Cameroon. Int J Epidemiol 27:181–185

  126. 126.

    Mitropoulous D, Plomidou K, Kyroudi-Voutgari A et al (2004) Effect of hypercholesterol diet (HD) on sex steroid plasma levels in rats [abstract]. Eur Urol 3(2):74

  127. 127.

    WHO Guidance Subcommittee (1999) World Health Organization International Society for Hypertension guidelines for the management of hypertension. J Hypertens 17:151–183

  128. 128.

    Mollentze WF, Moore AJ, Steyn A (1995) Coronary heart disease risk factors in a rural and urban Orange Free State black population. S Afr Med J 85:90–97

  129. 129.

    Njelekela M, Negishi H, Nara Y et al (2001) Cardiovascular risk factors in Tanzania: a revisit. Acta Trop 79:231–239

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Correspondence to Chukwunonso E. C. C. Ejike.

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Ejike, C.E.C.C., Ezeanyika, L.U.S. Metabolic syndrome in sub-Saharan Africa: “smaller twin” of a region’s prostatic diseases?. Int Urol Nephrol 40, 909–920 (2008).

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  • Benign prostate hyperplasia
  • Metabolic syndrome
  • Prostate cancer
  • Sub-Saharan Africa