The Prevalence of Diabetes among Hypertensive Polish in Relation to Sex-Difference in Body Mass Index, Waist Circumference, Body Fat Percentage and Age

Abstract

Background: Little is known about sex differences in the risk of type 2 diabetes (DM2) development related to body fat depot. The main aim of this study was to assess sex-specific differences in the prevalence of diabetes in the relation to body mass, body mass index (BMI), waist circumference (WC), and calculated body fat percentage (BF), adjusted by physical activity, in younger and older hypertensive adults. Subjects/Methods: The survey enrolled 12,289 adult hypertensive outpatients with body weight, height, and WC reported by their physicians across Poland. Prevalence of diabetes was plotted against body mass, BMI, WC, and calculated BF and adjusted by the self-reported level of physical activity. Results: In our cohort, younger women (<60 years) with BMI < 25.0 kg/m2 had lower adjusted prevalence of diabetes than corresponding men (3.4% vs. 6.5%), while among older (≥60 years) with BMI < 25.0 kg/m2, the prevalence of diabetes was greater in women than in men (19.4% vs. 11.2%). A 25% probability of diabetes was observed for younger women with lower BMI than younger men (32.1 kg/m2 and 35.3 kg/m2, respectively) and WC (100.7 cm and 116.1 cm, respectively) but greater BF (45.5% and 38.9%, respectively). The corresponding differences in BMI and WC in older ones were much smaller (27.6 kg/m2 and 27.2 kg/m2, respectively; 83.7 cm and 85.6 cm, respectively), but not for BF (40.7% and 30.1%, respectively). A doubling of diabetes probability (from 25% to 50%), adjusted by physical activity, was attributable to the lower increase in BMI and WC and BF in women than in men (6.3 vs. 9.8 kg/m2, 25.0 vs. 36.1 cm, and 6.5 vs. 10.8%, for younger, and 8.1 vs. 11.3 kg/m2, 26.2 vs. 73.2 cm and 8.8 vs. 13.3%, for older). Conclusions: This study shows a lower probability of diabetes in younger women than younger men with normal weight BMI ranges, adjusted to physical activity. This probability is greater for hypertensive women, regardless of age, due to the increase in BMI/WC and BF values adjusted for physical activity.

Keywords: epidemiology; obesity; physical activity; sex-specific effect; visceral obesity.

Figure 1

The analysis flow chart.

Figure 2

Occurrence of diabetes in younger and older women and men according to BMI categories without (upper panel) and after adjustment to physical activity (lower panel).

Figure 3

Probability of diabetes occurrence in younger and older men and women in relation to anthropometric parameters. Body mass index (BMI) of 25 kg/m² was associated with the probability of diabetes of 8.3% and 18.9% in younger and older women, respectively, and of 9.5% and 22.9% in younger and older men, respectively. BMI 30 kg/m² with 18.4% and 31.6% in younger and older women, respectively, and 15.6% and 27.8% in younger and older men, respectively. BMI 35 kg/m² with 36.0% and 47.7% in younger and older women, respectively, and 24.4% and 33.2% in younger and older men, respectively. Waist circumference (WC) of 80 cm with 11.9% and 22.2% and 88 cm with 16.0% and 28.5% in younger and older women, respectively. WC of 94 cm with 14.5% and 27.4% and 102 cm with 17.8% and 29.9% in younger and older men, respectively.