Endocrine Abstracts

Introduction

Obesity is a global health challenge, with more than 50% of the world´s obese population residing in LMICs. Although adiposity is a well-known major risk factor for noncommunicable diseases (NCDs) such as hypertension, and diabetes mellitus, the delivery of effective NCDs interventions is still a challenge to health systems. About 85% of the NCDs premature deaths occur in LMICs. Obesity is more prevalent in women than men, however the burden of obesity and its association with NCDs in women from LMICs is unknown. We performed a systematic review and meta-analysis to assess the prevalence of obesity and metabolic complications in adult women from LMICs.

Methods

MEDLINE, EMBASE and Cochrane were searched from inception to February 2020. Cross-sectional and cohort studies that reported prevalence of obesity from LMICs were included. Prevalence (95%CI) of obesity and metabolic outcomes were assessed and stratified according to World Bank Region, country´s income status, setting, and year of the study. Meta-regression was performed for the association between the risk of obesity, hypertension, and T2 diabetes and age.

Results

From the 11.189 citations identified, 218 studies were eligible for analysis (376.405 women in 63 countries). Overall prevalence of obesity, hypertension, and type 2 diabetes in women were 22% (95% CI 20–24%), 26% (95% CI 23–30%), and 7% (95% CI 6–9%), respectively. Prevalence varied according to World Bank Region (P < 0.001), country´s income status (P < 0.001) and setting (P < 0.001). Higher rates of obesity, hypertension, and type 2 diabetes were found in upper-middle countries and urban setting. Obesity increased the risk of hypertension [OR: 2.43 (95% CI 2.19–2.80)] and type 2 diabetes [OR: 2.84 (95% CI 2.16–3.74)] in women. Overall, women presented almost a 3-fold increase of the risk of obesity [OR: 2.75 (95% CI 2.50–3.02)] as compared to men. Meta-regression suggests a positive association between women´s age and the prevalence of obesity [1.045 (95% CI:1.03–1.06, P < 0.001)], hypertension [1.085 (95% CI:1.07–1.10, P < 0.001)] and T2 diabetes [1.076 (95% CI:1.03–1.12, P < 0.001)]. Same association was found for the risk of obesity in women, irrespective of age difference between women and men [1.019 (95% CI:0.99–1.05, P < 0.232)].

Conclusion

Women are disproportionately affected with obesity compared to men in LMICs. It is therefore essential for decision-makers to develop appropriate strategies to tackle obesity and its complications in the female population in LMICs.