Participant recruitment, baseline characteristics and burden of cardiometabolic risk markers among adults with prediabetes in Kenya: insights from the fermented foods and prediabetes study

Aims: Cardiometabolic abnormalities such as obesity, hypertension, and dyslipidemia are rising globally and straining health systems. This study assessed the burden of cardiometabolic risk factors among prediabetic adults in Kenya. Methods: We analyzed baseline data from the Fermented Foods and Prediabetes Randomized Controlled Trial, which recruited adults with prediabetes (HbA1c 39–46 mmol/mol; 5.7%–6.4%) from Aga Khan University Hospital outreach clinics in five Kenyan counties. Standardized questionnaires and clinical assessments were conducted, with HbA1c measured via turbidimetric inhibition immunoassay. Data were managed in REDCap and analyzed in Stata v13. Poisson regression identified factors associated with co-occurrence of cardiometabolic risk factors. Results: Of 210 participants (mean age 44.1 years; 60.5% female), 96.2% had at least one additional metabolic abnormality alongside prediabetes, including 16.7% with normal BMI. Excess weight was present in 83.3% and elevated blood pressure in 77.1%. In adjusted analyses, age was independently associated with a higher number of cardiometabolic risk factors (IRR = 1.013; 95% CI: 1.005–1.021; p = 0.002). Conclusion: Prediabetic adults in Kenya exhibit a high clustering of cardiometabolic abnormalities, highlighting elevated risk of type 2 diabetes, cardiovascular disease, and premature mortality. Comprehensive interventions should target glucose, weight, blood pressure, lipids, and lifestyle factors.