Gender differences in associations between obesity and hypertension, diabetes, dyslipidemia: evidence from electronic health records of 3.5 million Chinese senior population.

BACKGROUND

Obesity has been arousing a critical public health issue, and posting threats to senior population. We aimed to explore gender differences in associations between general/central obesity (body mass index/waist circumference) and hypertension, diabetes, dyslipidemia based on electronic health records of 3.5 million Chinese senior population over 65 years.

METHODS

3571189 electronic health records of Chinese senior population were collected from platform of Zhejiang provincial Basic Public Health Services Project. Sociodemographic characteristics, behavioral lifestyle, physical data, and biochemical indices were included in the research. Multivariate logistic regression models and restricted cubic spline models were used to explore associations between obesity and diseases.

RESULTS

7.7% (5.3% for male, 9.7% for female) senior population were having general obesity, and 31.8% (25.2% for male, 37.4% for female) of them had central obesity. 48.0% (46.0% for male, 49.7% for female), 14.0% (12.3% for male, 15.5% for female), and 58.9% (51.6% for male, 65.2% for female) senior population were having hypertension, diabetes, and dyslipidemia, respectively. 37.9% (29.5% for male, 45.1% for female) and 33.7% (28.1% for male, 38.5% for female) senior population were having abnormal TC and TG, respectively. General obesity and central obesity strongly and negatively associated with hypertension [OR = 2.61 (95%CI: 2.58-2.63), and 2.20 (95%CI: 2.18-2.21)], diabetes [OR = 1.33 (95%CI: 1.31-1.35), and 1.56 (95%CI: 1.54-1.57)], and dyslipidemia [OR = 1.66 (95%CI: 1.64-1.68), and 1.84 (95%CI: 1.83-1.85)] based on existing obesity standards. Male population with BMI higher than 28.7 kg/m, 30.1 kg/m, 22.7 kg/m, and with WC higher than 99.0 cm, 95.9 cm, 82.1 cm, while female population with BMI higher than 26.9 kg/m, 23.3 kg/m, 18.1 kg/m, and with WC higher than 92.1 cm, 83.1 cm, 65.7 cm, the ORs were over 1.0 for having hypertension, diabetes, and dyslipidemia, respectively.

CONCLUSIONS

Senior population were more likely to have central obesity over general obesity, and nearly half of them were having hypertension and dyslipidemia. Obesity negatively and strongly associated with chronic diseases in senior population, yet general obesity exerted more impact on hypertension, whereas central obesity exerted more impact on diabetes and dyslipidemia. Female population with obesity were in higher risk than male having hypertension, diabetes, and dyslipidemia. We recommended senior population control BMI lower than 28.7 kg/m and 23.3 kg/m, as well as WC lower than 95.9 cm and 83.1 cm for male and female, respectively. Optimal BMI and WC in senior population may be around the overweight or mild obesity range. There were risks for having dyslipidemia or abnormal lipid-related indices even in senior population without obesity. TC and TG were major indicators of discovering disease and preventing senior population from dyslipidemia.