Gender Differential Prevalence of Overweight and Obesity, Hypertension and Diabetes in South India: A Population-Based Cross-Sectional Study

Mohanraj Sundaresan; Ganesan Velmurugan; Mani Dhivakar; Arulraj Ramakrishnan; Mathew Cherian; Thomas Alexander; Krishnan Swaminathan

doi:10.5334/gh.1354

Gender Differential Prevalence of Overweight and Obesity, Hypertension and Diabetes in South India: A Population-Based Cross-Sectional Study

Volume 19 (2024): Issue 1

By: Mohanraj Sundaresan , Ganesan Velmurugan , Mani Dhivakar, Arulraj Ramakrishnan , Mathew Cherian, Thomas Alexander and Krishnan Swaminathan

Open Access

|Sep 2024

Figures & Tables

Table 1

Sociodemographic characteristic of study participants in rural, sub-urban and urban population (Values are n (%)).

	TOTAL			NALLAMPATTI (RURAL; n = 865)			THADAGAM (SUB-URBAN; n = 1030)			KALAPATTI (URBAN; n = 1081)			OVER ALL P VALUE
	MEN (n = 1322)	WOMEN (n = 1654)	P VALUE	MEN (n = 415)	WOMEN (n = 450)	P VALUE	MEN (n = 469)	WOMEN (n = 561)	P VALUE	MEN (n = 438)	WOMEN (n = 643)	P VALUE	OVER ALL P VALUE
Age group, years
20–39	327(24.7)	471(28.5)	0.001	119(28.7)	133(29.6)	0.046	108(23)	134(23.9)	0.247	100(22.8)	204(31.7)	0.004	0.001
40–59	600(45.4)	783(47.3)		177(42.7)	219(48.7)		205(43.7)	267(47.6)		218(49.8)	297(46.2)
≥60	395(29.9)	399(24.1)		119(28.7)	97(21.6)		156(33.3)	160(28.5)		120(27.4)	142(22.1)
Missing data		1(0.1)			1(0.2)
Age, years Mean (SD) [95% CI]	50.47(14.5) [49–51]	47.94(13.7) [47–48]	<0.001	49.61(14.2) [48–50]	47.08(13.0) [45–48]	0.007	51.47(15.1) [50–52]	49.35(14.1) [48–50]	0.021	50.2(14.1) [48–51]	47.32(13.7) [46–48]	0.001	0.002
Education
None	179(13.5)	523(31.6)	<0.001	66(15.9)	174(38.7)	<0.001	79(16.8)	204(36.4)	<0.001	34(7.8)	145(22.6)	<0.001	<0.001
Primary	308(23.3)	348(21)		98(23.6)	94(20.9)		133(28.4)	154(27.5)		77(17.6)	100(15.6)
Secondary	517(39.1)	525(31.7)		180(43.4)	138(30.7)		166(35.4)	145(25.8)		171(39)	242(37.6)
Degree	313(23.7	256(15.5)		71(17.1)	43(9.6)		88(18.8)	57(10.2)		154(35.2)	156(24.3)
Missing data	5(0.4)	2(0.1)			1(0.2)			1(0.2)		2(0.5)
Employment
Not-working	108(8.2)	681(41.2)	<0.001	8(1.9)	49(10.9)	<0.001	57(12.2)	299(53.3)	<0.001	43(9.8)	333(51.8)	<0.001	<0.001
Employed	1214(91.8)	973(58.8)		407(98.1)	401(89.1)		412(87.8)	262(46.7)		395(90.2)	310(48.2)

Table 2

Prevalence of obesity, hypertension, diabetes and life style risk factors among rural, sub-urban and urban population.

	TOTAL			NALLAMPATTI (RURAL; n = 865)			THADAGAM (SUB-URBAN; n = 1030)			KALAPATTI (URBAN; n = 1081)			P VALUE
	MEN (n = 1322)	WOMEN (n = 1654)	P VALUE	MEN (n = 415)	WOMEN (n = 450)	P VALUE	MEN (n = 469)	WOMEN (n = 561)	P VALUE	MEN (n = 438)	WOMEN (n = 643)	P VALUE	P VALUE
Obesity
Underweight	145(11)	186(11.2)	<0.001	52(12.5)	62(13.8)	0.692	73(15.6)	74(13.2)	0.034	20(4.6)	50(7.8)	<0.001	<0.001
Normal	715(54.1)	785(47.5)		233(56.1)	246(54.7)		254(54.2)	273(48.7)		228(52.1)	266(41.4)
Overweight	378(28.6)	490(29.6)		113(27.2)	116(25.8)		112(23.9)	156(27.8)		153(34.9)	218(33.9)
Obesity	78(5.9)	189(11.4)		17(4.1)	25(5.6)		28(6)	55(9.8)		33(7.5)	109(17)
Missing data	6(0.5)	4(0.2)			1(0.2)		2(0.4)	3(0.5)		4(0.9)
Mean (SD) BMI	23.76(6.8)	24.29(4.7)	0.014	23.3(3.9)	23.19(4.2)	0.675	23.23(6.2)	23.8(4.5)	0.084	24.7(9.2)	25.4(5)	0.114	<0.001
Hypertension
Normal	696(52.6)	1051(63.5)	<0.001	241(58.1)	309(68.7)	0.001	218(46.5)	327(58.3)	<0.001	237(54.1)	415(64.5)	<0.001	<0.001
Hypertension	626(47.4)	603(36.5)		174(41.9)	141(31.3)		251(53.5)	234(41.7)		201(45.9)	228(35.5)
Mean (SD) Systolic blood pressure	133.36(19.8)	127.14(22.8)	<0.001	134.01(19.3)	128.06(22)	<0.001	133.35(19.9)	127.7(23.6)	<0.001	132.76(20.2)	126.02(22.6)	<0.001	0.074
Mean (SD) Diastolic blood pressure	81.62(11.5)	77.07(11.5)	<0.001	84.75(11.5)	79.65(11.4)	<0.001	80.19(11.4)	76.8(11.3)	<0.001	80.17(11.23)	75.48(11.5)	<0.001	<0.001
Diabetes
Normal	546(41.3)	685(41.4)	<0.001	166(40)	177(39.3)	0.004	191(40.7)	225(40.1)	0.086	189(43.2)	283(44)	0.001	<0.001
Prediabetes	425(32.1)	646(39.1)		160(38.6)	210(46.7)		142(30.3)	201(35.8)		123(28.1)	235(36.5)
Diabetes	341(25.8)	313(18.9)		83(20)	56(12.4)		134(28.6)	132(23.5)		124(28.3)	125(19.4)
Missing data	10(0.8)	10(0.6)		6(1.4)	7(1.6)		2(0.4)	3(0.5)		2(0.5)
Mean (SD) HbA1c	6.23(1.5)	6.08(1.3)	0.004	6.06(1.2)	5.92(0.9)	0.063	6.29(1.6)	6.16(1.4)	0.163	6.32(1.5)	6.12(1.3)	0.026	<0.001
Number of conditions; Multimorbidity (Obesity, Hypertension and Diabetes)
One	512(38.7)	517(31.3)	<0.001	159(38.3)	132(29.3)	<0.001	187(39.9)	195(34.8)	<0.001	166(37.9)	190(29.5)	0.001	<0.001
Two	247(18.7)	225(13.6)		56(13.5)	39(8.7)		104(22.2)	80(14.3)		87(19.9)	106(16.5)
Three	13(1.0)	46(2.8)		1(0.2)	4(0.9)		6(1.3)	22(3.9)		6(1.4)	20(3.1)
Normal	550(41.6)	866(52.4)		199(48)	275(61.1)		172(36.7)	264(47.1)		179(40.9)	327(50.9)
Smoking
Smoker	518(39.2)	0	<0.001	209(50.4)	0	<0.001	170(36.2)	0	<0.001	139(31.7)	0	<0.001	<0.001
Non-smoker	804(60.8)	1654 (100)		206(49.6)	450(100)		299(63.8)	561(100)		299(68.3)	643(100)
Alcohol consumption
Drinker	531(40.2)	0	<0.001	199(48)	0	<0.001	159(33.9)	0	<0.001	173(39.5)	0	<0.001	<0.001
Non-drinker	791(59.8)	1654 (100)		216(52)	450(100)		310(66.1)	561(100)		265(60.5)	643(100)
Tobacco
Chewing	213(16.1)	461(27.9	<0.001	83(20)	114(25.3)	0.063	77(16.4)	182(32.4)	<0.001	53(12.1)	165(25.7)	<0.001	<0.001
Non-Chewing	1109(83.9)	1193(72.1)		332(80)	336(74.7)		392(83.6)	379(67.6)		385(87.9)	478(74.3)

[i] BMI: Body-mass index; Values are n (%).

Table 3

Associations of risk factors with overweight and obesity; Gender-specific unadjusted and adjusted risk ratios.

	MALE (n = 1322)				FEMALE (n = 1654)
	UNADJUSTED		ADJUSTED; AGE & GEOGRAPHICAL		UNADJUSTED		ADJUSTED; AGE & GEOGRAPHICAL
	ODD RATIO (95% CI)	P VALUE	ODD RATIO (95% CI)	P VALUE	ODD RATIO (95% CI)	P VALUE	ODD RATIO (95% CI)	P VALUE
Age Groups, years
20–39	1(ref)		1(ref)		1(ref)		1(ref)
40–59	1.28(0.94–1.74)	0.11	1.46(0.92–2.32)	0.1	1.41(1.07–1.86)	0.014	1.26(0.84–1.88)	0.26
≥60	0.63(0.43–0.94)	0.023	0.83(0.38–1.84)	0.661	0.66(0.45–0.97)	0.036	0.52(0.25–1.07)	0.078
Hypertension
Normal	1(ref)		1(ref)		1(ref)		1(ref)
Hypertension	1.89(1.47–2.44)	<0.001	1.91(1.48–2.46)	<0.001	2.28(1.78–2.92)	<0.001	2.23(1.74–2.88)	<0.001
Diabetes
Normal	1(ref)		1(ref)		1(ref)		1(ref)
Diabetes	1.39(1.05–1.84)	0.021	1.41(1.06–1.87)	0.017	1.86(1.4–2.46)	<0.001	1.84(1.39–2.44)	<0.001
Education
None	1(ref)		1(ref)		1(ref)		1(ref)
Primary	2.49(1.51–4.08)	<0.001	2.49(1.51–4.08)	<0.001	1.5(1.1–2.04)	0.009	1.51(1.11–2.06)	0.008
Secondary	3.76(2.34–6.04)	<0.001	3.71(2.31–5.97)	<0.001	2.02(1.5–2.73)	<0.001	2.05(1.51–2.78)	<0.001
Degree	4.27(2.56–7.12)	<0.001	4.15(2.47–6.95)	<0.001	2.29(1.56–3.36)	<0.001	2.37(1.6–3.5)	<0.001
Smoking (Male only)
Non-Smoker	1(ref)		1(ref)
Current Smoker	0.78(0.59–1.03)	0.088	0.79(0.6–1.04)	0.096
Alcohol (Male only)
Non-drinker	1(ref)		1(ref)
Drinker	1.41(1.08–1.84)	0.11	1.4(1.07–1.83)	0.013
Tobacco
Non-Chewing	1(ref)		1(ref)		1(ref)		1(ref)
Tobacco chewing	1.19(0.85–1.67)	0.296	1.2(0.85–1.68)	0.287	0.77(0.59–1.0)	0.051	0.77(0.59–0.99)	0.05
Employment status
Not-working	1(ref)		1(ref)		1(ref)		1(ref)
Employed	0.99(0.62–1.59)	0.987	1.0(0.62–1.6)	0.998	1.49(1.2–1.85)	<0.001	1.48(1.19–1.84)	<0.001

Table 4

Associations of risk factors with hypertension; Gender-specific unadjusted and adjusted risk ratios.

	MEN (n = 1322)						WOMEN (n = 1654)
	UNADJUSTED		ADJUSTED; AGE & GEOGRAPHICAL		ADJUSTED; AGE, GEOGRAPHICAL & BMI		UNADJUSTED		ADJUSTED; AGE & GEOGRAPHICAL		ADJUSTED; AGE, GEOGRAPHICAL & BMI
	ODD RATIO (95% CI)	P VALUE	ODD RATIO (95% CI)	P VALUE	ODD RATIO (95% CI)	P VALUE	ODD RATIO (95% CI)	P VALUE	ODD RATIO (95% CI)	P VALUE	ODD RATIO (95% CI)	P VALUE
Age Groups, years
20–39	1(ref)		1(ref)		1(ref)		1(ref)		1(ref)		1(ref)
40–59	6.02(3.62–10.01)	<0.001	3.15(1.68–5.9)	<0.001	3.14(1.67–5.88)	<0.001	8.66(4.6–16.2)	<0.001	4.96(2.38–10.34)	<0.001	4.91(2.35–10.23)	<0.001
≥60	9.59(5.56–16.56)	<0.001	2.59(1.02–6.54)	0.043	2.59(1.02–6.53)	0.044	19.79(9.98–39.24)	<0.001	6.25(2.23–17.51)	<0.001	6.22(2.22–17.41)	<0.001
Hypertension
Normal	1(ref)		1(ref)		1(ref)		1(ref)		1(ref)		1(ref)
Hypertension	1.79(1.36–2.36)	<0.001	1.72(1.3–2.27)	<0.001	1.7(1.28–2.24)	<0.001	2.0(1.51–2.72)	<0.001	1.82(1.35–2.47)	<0.001	1.80(1.33–2.43)	<0.001
BMI Categories
Normal	1(ref)		1(ref)		1(ref)		1(ref)		1(ref)		1(ref)
Underweight	0.57(0.34–0.95)	0.033	0.56(0.33–0.94)	0.03	0.63(0.35–1.11)	0.11	0.36(0.19–0.69)	0.002	0.37(0.19–0.7)	0.003	0.47(0.22–1.02)	0.058
Overweight	1.27(0.94–1.72)	0.109	1.32(0.98–1.79)	0.067	1.2(0.83–1.73)	0.322	1.42(1.03–1.95)	0.03	1.45(1.05–2.0)	0.022	1.16(0.7–1.91)	0.562
Obesity	1.57(0.9–2.72)	0.107	1.58(0.91–2.76)	0.103	1.2(0.57–2.53)	0.622	2.31(1.55–3.45)	<0.001	2.43(1.63–3.64)	<0.001	1.49(0.59–3.78)	0.395
Education
None	1(ref)		1(ref)		1(ref)		1(ref)		1(ref)		1(ref)
Primary	1.04(0.67–1.62)	0.834	1.04(0.67–1.61)	0.849	1.0(0.66–1.6)	0.837	1.66(1.15–2.39)	0.006	1.76(1.21–2.54)	0.003	1.75(1.21–2.53)	0.003
Secondary	1.31(0.86–2)	0.207	1.39(0.91–2.14)	0.123	1.37(0.9–2.11)	0.139	1.43(0.98–2.09)	0.058	1.56(1.06–2.29)	0.022	1.54(1.05–2.27)	0.026
Degree	1.17(0.71–1.91)	0.529	1.29(0.78–2.14)	0.306	1.26(0.76–2.08)	0.357	2.09(1.21–3.62)	0.008	2.46(1.4–4.31)	0.002	2.43(1.38–4.26)	0.002
Smoking (Men only)
Non-Smoker	1(ref)		1(ref)		1(ref)
Current Smoker	0.99(0.74–1.34)	0.986	0.98(0.73–1.32)	0.908	0.97(0.72–1.31)	0.887
Alcohol (Men only)
Non-drinker	1(ref)		1(ref)		1(ref)
Drinker	1.18(0.88–1.59)	0.25	1.24(0.92–1.66)	0.154	1.23(0.91–1.65)	0.169
Tobacco
Non-Chewing	1(ref)		1(ref)		1(ref)		1(ref)		1(ref)		1(ref)
Tobacco chewing	0.78(0.54–1.12)	0.179	0.75(0.52–1.08)	0.126	0.75(0.52–1.09)	0.134	0.99(0.72–1.35)	0.955	0.97(0.71–1.33)	0.88	0.98(0.72–1.34)	0.926
Employment status
Not-working	1(ref)		1(ref)		1(ref)		1(ref)		1(ref)		1(ref)
Employed	1.15(0.73–1.82)	0.54	1.05(0.66–1.67)	0.832	1.07(0.67–1.7)	0.774	1.3(0.98–1.72)	0.064	1.21(0.91–1.61)	0.188	1.19(0.89–1.59)	0.222

Table 5

Associations of risk factors with diabetes; Gender-specific unadjusted and adjusted risk ratios.

	MEN (n = 1322)						WOMEN (n = 1654)
	UNADJUSTED		ADJUSTED; AGE & GEOGRAPHICAL		ADJUSTED; AGE, GEOGRAPHICAL & BMI		UNADJUSTED		ADJUSTED; AGE & GEOGRAPHICAL		ADJUSTED; AGE, GEOGRAPHICAL & BMI
	ODD RATIO (95% CI)	P VALUE	ODD RATIO (95% CI)	P VALUE	ODD RATIO (95% CI)	P VALUE	ODD RATIO (95% CI)	P VALUE	ODD RATIO (95% CI)	P VALUE	ODD RATIO (95% CI)	P VALUE
Age Groups, years
20–39	1(ref)		1(ref)		1(ref)		1(ref)		1(ref)		1(ref)
40–59	4.88(3.35–7.1)	<0.001	1.17(0.74–1.85)	0.486	1.17(0.74–1.85)	0.48	4.65(3.19–6.79)	<0.001	1.03(0.61–1.72)	0.91	1.02(0.61–1.71)	0.917
≥60	1.92(1.4–2.64)	<0.001	1.75(0.81–3.79)	0.154	1.78(0.82–3.87)	0.141	15.58(9.98–24.2)	<0.001	0.69(0.3–1.59)	0.391	0.7(0.3–1.63)	0.419
Diabetes
Normal	1(ref)		1(ref)		1(ref)		1(ref)		1(ref)		1(ref)
Diabetes	1.79(1.35–2.36)	<0.001	1.71(1.29–2.25)	<0.001	1.64(1.24–2.18)	<0.001	2.01(1.5–2.7)	<0.001	1.8(1.33–2.43)	<0.001	1.77(1.31–2.39)	<0.001
BMI Categories
Normal	1(ref)		1(ref)		1(ref)		1(ref)		1(ref)		1(ref)
Underweight	0.39(0.25–0.6)	<0.001	0.39(0.25–0.6)	<0.001	0.62(0.35–1.11)	0.111	0.63(0.41–0.97)	0.036	0.69(0.44–1.08)	0.106	1.20(0.67–2.15)	0.527
Overweight	1.65(1.26–2.17)	<0.001	1.67(1.27–2.2)	<0.001	1.11(0.72–1.72)	0.618	2.03(1.54–2.67)	<0.001	2.08(1.57–2.76)	<0.001	1.22(0.77–1.92)	0.39
Obesity	1.73(1.05–2.85)	0.03	1.73(1.05–2.86)	0.031	0.7(0.28–1.71)	0.436	2.34(1.61–3.42)	<0.001	2.58(1.75–3.79)	<0.001	0.82(0.35–1.93)	0.663
Education
None	1(ref)		1(ref)		1(ref)		1(ref)		1(ref)		1(ref)
Primary	1.2(0.8–1.8)	0.37	1.2(0.8–1.8)	0.37	1.17(0.78–1.76)	0.442	0.93(0.67–1.3)	0.706	1.06(0.76–1.48)	0.713	1.05(0.75–1.47)	0.76
Secondary	0.96(0.65–1.43)	0.872	1.01(0.66–1.65)	0.926	0.98(0.66–1.45)	0.929	0.83(0.6–1.15)	0.27	1.03(0.73–1.44)	0.852	1.01(0.72–1.41)	0.954
Degree	0.88(0.56–1.37)	0.586	0.98(0.62–1.54)	0.935	0.93(0.59–1.46)	0.761	0.471(0.29–0.75)	0.002	0.71(0.43–1.17)	0.188	0.70(0.42–1.15)	0.163
Smoking (Men only)
Non-Smoker	1(ref)		1(ref)		1(ref)
Current Smoker	0.72(0.55–0.94)	0.017	0.7(0.54–0.92)	0.012	0.71(0.54–0.93)	0.014
Alcohol (Men only)
Non-drinker	1(ref)		1(ref)		1(ref)
Drinker	1.21(0.93–1.58)	0.14	1.25(0.96–1.63)	0.092	1.22(0.94–1.59)	0.13
Tobacco
Non-Chewing	1(ref)		1(ref)		1(ref)		1(ref)		1(ref)		1(ref)
Tobacco chewing	0.83(0.6–1.14)	0.83	0.81(0.58–1.12)		0.81(0.59–1.13)	0.222	0.75(0.57–0.99)	0.046	0.73(0.55–0.97)	0.031	0.75(0.56–0.99)	0.045
Employment status
Not-working	1(ref)		1(ref)		1(ref)		1(ref)		1(ref)		1(ref)
Employed	1.1(0.71–1.73)	0.647	1.05(0.66–1.65)	0.825	1.10(0.7–1.74)	0.666	1.41(1.11–1.8)	0.005	1.18(0.91–1.52)	0.199	1.15(0.89–1.48)	0.272

Venn diagrams showing the overlapping prevalence of obesity, hypertension, and diabetes in the total population and stratified by gender.

Articles in this issue

DOI: https://doi.org/10.5334/gh.1354 | Journal eISSN: 2211-8179

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Language: English

Submitted on: Feb 14, 2024

Accepted on: Aug 24, 2024

Published on: Sep 9, 2024

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

Non communicable disease,

Obesity,

Hypertension,

Diabetes,

Multimorbidity

© 2024 Mohanraj Sundaresan, Ganesan Velmurugan, Mani Dhivakar, Arulraj Ramakrishnan, Mathew Cherian, Thomas Alexander, Krishnan Swaminathan, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 19 (2024): Issue 1

Gender Differential Prevalence of Overweight and Obesity, Hypertension and Diabetes in South India: A Population-Based Cross-Sectional Study

Figures & Tables

Table 1

Table 2

Table 3

Table 4

Table 5

Figure 1

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