RF12 | PSUN117 Sex-Specific Obesity and Cardiometabolic Disease Risks In Low- and Middle-Income Countries: A Meta-Analysis Involving 2,624,289 Individuals

BACKGROUND: Obesity is a leading cause of preventable deaths from cardiometabolic diseases worldwide. About two-thirds of all individuals with obesity live in low- and middle-income countries (LMICs), facing an epidemiological transition from predominantly infectious to non-communicable diseases burden. The magnitude of sex-related disparities in the risk of obesity and cardiometabolic diseases in LMICs, and if these vary by region, country's income status, setting, and time is unclear. We undertook a systematic review and meta-analysis to assess the magnitude of sex-specific disparities in the prevalence of obesity and cardiometabolic diseases in LMICs, their burden on women, and variations by region, country's income status, setting, and time. METHODS: We searched MEDLINE and EMBASE (from inception to September 2021). Two independent reviewers selected the studies, assessed their quality, and performed data extraction. We used a random-effects model to obtain pooled estimates of odds ratios and 95% confidence interval (95%CI) for the association between sex and obesity and cardiometabolic diseases and rates of relevant outcomes. RESULTS: We included 287 studies (2,624,289 individuals). The risk of obesity was 2.72-fold (OR 2.72, 95% CI 2.54-2.91) higher in women than men, independent of age. The sex-specific disparities varied by World Bank region, with the greatest difference in Sub-Saharan Africa (OR 3.70, 95% CI 2.25-6.08), but it did not vary by the country's income status, setting, or overtime. There were no differences between the sexes in the type 2 diabetes or hypertension rates. Amongst women in LMICs, 22% (95% CI 0.20-0.24) had obesity, 27% (95% CI 0.24-0.30) hypertension, and 7% (95% CI 0.06-0.09) type 2 diabetes. The rates of obesity, hypertension and type 2 diabetes in women varied by region and country's income status, with the highest rates in the Middle East and North-Africa, and in upper-middle-income countries; obesity and type 2 diabetes rates were highest in urban settings. The odds of hypertension (OR 2.43, 95% CI 2.9-2.80) and type 2 diabetes (OR 2.84, 95% CI 2.16-3·74) were doubled in women with vs without obesity. CONCLUSIONS: Women are disproportionately affected by obesity compared to men in LMICs, with the greatest disparity observed in the Sub-Saharan region. Obesity rates were consistently higher in women than men irrespective of the country's income status (low, low-middle, upper-middle), setting (rural, urban) or overtime. Amongst women, obesity and cardiometabolic diseases prevalence vary by World Bank region and country's income status. Obesity doubles the risk of hypertension and type 2 diabetes in women in LMICs. Our findings call for urgent sex-specific and region-stratified actions targeting obesity awareness, prevention, treatment, and control in women in LMICs. Implementing cost-effective and sustainable programmes specific to women and addressing obesity's burden should be an urgent public health priority in LMICs. Presentation: Saturday, June 11, 2022 1:12 p.m. - 1:17 p.m., Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.