Abstract
Context: There is limited knowledge about the disparities between the sexes in obesity prevalence and associated cardiovascular complications
in low- and middle-income countries (LMICs).
Objective: We undertook a systematic review and meta-analysis to assess sex-specific disparities in the prevalence of obesity and
cardiometabolic diseases in LMICs, the burden in women, and variations by region, country’s income status, setting, and time.
Methods: We searched major databases from inception to March 2023. Two independent reviewers selected the studies, assessed their
quality, and extracted data. We used DerSimonian and Laird random-effects models to obtain pooled estimates of odds ratios and 95% CI for
the association between sex and obesity and cardiometabolic diseases, and multilevel random-effects logistic regression models to estimate
the prevalence of relevant outcomes (PROSPERO CRD42019132609).
Results: We included 345 studies (3 916 276 individuals). The odds of obesity were 2.72-fold higher in women than men (OR 2.72; 95% CI, 2.54-
2.91). The sex-specific disparities varied by region, with the greatest disparities in Sub-Saharan Africa (OR 3.91; 95% CI, 3.49-4.39). Among
women in LMICs, 23% (95% CI, 21%-25%) had obesity, 27% (95% CI, 24%-29%) had hypertension, and 7% (95% CI, 6%-9%) had type 2
diabetes. The prevalence of obesity and type 2 diabetes in women varied by region, country’s income, and setting, with the highest
prevalence in the Middle East and North Africa, upper-middle-income countries and urban settings. The odds of hypertension (OR 2.41; 95%
CI, 1.89-3.08) and type 2 diabetes (OR 2.65; 95% CI, 1.76-3.98) were doubled in women with vs without obesity.
Conclusion: There is an urgent need for a women-centred and region-stratified approach to tackle obesity awareness, treatment, and prevention in women in LMICs.
in low- and middle-income countries (LMICs).
Objective: We undertook a systematic review and meta-analysis to assess sex-specific disparities in the prevalence of obesity and
cardiometabolic diseases in LMICs, the burden in women, and variations by region, country’s income status, setting, and time.
Methods: We searched major databases from inception to March 2023. Two independent reviewers selected the studies, assessed their
quality, and extracted data. We used DerSimonian and Laird random-effects models to obtain pooled estimates of odds ratios and 95% CI for
the association between sex and obesity and cardiometabolic diseases, and multilevel random-effects logistic regression models to estimate
the prevalence of relevant outcomes (PROSPERO CRD42019132609).
Results: We included 345 studies (3 916 276 individuals). The odds of obesity were 2.72-fold higher in women than men (OR 2.72; 95% CI, 2.54-
2.91). The sex-specific disparities varied by region, with the greatest disparities in Sub-Saharan Africa (OR 3.91; 95% CI, 3.49-4.39). Among
women in LMICs, 23% (95% CI, 21%-25%) had obesity, 27% (95% CI, 24%-29%) had hypertension, and 7% (95% CI, 6%-9%) had type 2
diabetes. The prevalence of obesity and type 2 diabetes in women varied by region, country’s income, and setting, with the highest
prevalence in the Middle East and North Africa, upper-middle-income countries and urban settings. The odds of hypertension (OR 2.41; 95%
CI, 1.89-3.08) and type 2 diabetes (OR 2.65; 95% CI, 1.76-3.98) were doubled in women with vs without obesity.
Conclusion: There is an urgent need for a women-centred and region-stratified approach to tackle obesity awareness, treatment, and prevention in women in LMICs.
| Original language | English |
|---|---|
| Article number | dgad599 |
| Pages (from-to) | 1-9 |
| Number of pages | 9 |
| Journal | Journal of Clinical Endocrinology and Metabolism |
| DOIs | |
| Publication status | Published - 1 Nov 2023 |
Keywords
- women’s health
- obesity
- Developing countries
- Meta-analysis
- sex-specific
