|Year : 2021 | Volume
| Issue : 2 | Page : 51-56
Prevalence of obesity, hypertension, and diabetes among patients attending outpatient clinic at a tertiary health institution in Southwestern Nigeria
Adeola Beatrice Adetola1, Ime Ani2, Jeremiah Eti-Inyene Matthew1, Grace Bosede Abodunde3
1 Department of Dietetics, Babcock University Teaching Hospital, Ilisan-Remo, Nigeria
2 Department of Human Nutrition and Dietetics, Babcock University, Ilisan-Remo, Nigeria
3 Issachar Medical Center, Ojo Ibadan, Oyo State, Nigeria
|Date of Submission||06-Aug-2021|
|Date of Acceptance||08-Jan-2022|
|Date of Web Publication||10-Dec-2022|
Ms. Adeola Beatrice Adetola
Department of Dietetics, Babcock University Teaching Hospital, Ilisan-Remo, Ogun State
Source of Support: None, Conflict of Interest: None
Background: The prevalence of noncommunicable diseases such as obesity, hypertension, diabetes, etc., has been on the increase globally. The study assessed the prevalence and association between obesity, hypertension, and diabetes among patients visiting the dietetics outpatient clinic of Babcock University Teaching Hospital.
Methodology: The prevalence and association between obesity, hypertension, and diabetes were assessed in this retrospective study. The study was conducted at the outpatient clinic of the Dietetics Department, Babcock University Teaching Hospital Ilisan-Remo Ogun State. Age, gender, height, weight, and diagnosed diseases were extracted from the record of individuals who presented at the clinic for 75 months. Data obtained were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.
Result: A total of 1059 patient's record was used in the study. The prevalence of obesity, hypertension, and diabetes were 58.9%, 37.4%, and 18.9%, respectively. Obesity and diabetes were prevalent among females than males (m = 20.4%, f = 38.5%), (m = 8.8%, f = 10.1%), while hypertension was prevalent among males (m = 19%, f = 18.4%). Diabetes was prevalent among older adults, while obesity and hypertension were prevalent among adolescents and young adults (23.9%). Obesity was significantly associated with hypertension (P < 0.05), and diabetes (P < 0.05).
Conclusion: The prevalence of obesity, hypertension, and diabetes in this study was high. Obesity and hypertension were prevalent among adolescents and young adults.
Keywords: Adolescent, blood glucose, blood pressure, body mass index, clinic, patients, prevalence
|How to cite this article:|
Adetola AB, Ani I, Matthew JE, Abodunde GB. Prevalence of obesity, hypertension, and diabetes among patients attending outpatient clinic at a tertiary health institution in Southwestern Nigeria. Nig J Cardiol 2021;18:51-6
|How to cite this URL:|
Adetola AB, Ani I, Matthew JE, Abodunde GB. Prevalence of obesity, hypertension, and diabetes among patients attending outpatient clinic at a tertiary health institution in Southwestern Nigeria. Nig J Cardiol [serial online] 2021 [cited 2023 May 29];18:51-6. Available from: https://www.nigjcardiol.org/text.asp?2021/18/2/51/363143
| Introduction|| |
Noncommunicable diseases (NCDs) has been well established to be the leading cause of death in the world with its burden increasing globally in both developing and developed nations. The prevalence of NCDs such as obesity, hypertension, diabetes, dyslipidemia, and metabolic syndrome has been on the increase globally. They were reported to be responsible for 63% of the 57 million deaths that occurred in 2008 with globalization, rapid urbanization, westernization, and nutrition transition contributing to the surge.,, As of 2011, there were 366 million people living with diabetes mellitus and this is expected to rise to 522 million by 2030. Over 600 million people are currently hypertensive and this figure is predicted to increase to 1.56 billion people by the year 2025., A greater burden of these diseases will more likely be suffered by underdeveloped and developing nations due to insufficient health-care financing for NCDs, and poor health facilities.,,,
The prevalence of diseases such as obesity, hypertension, and diabetes mellitus is increasing in Nigeria. This could be a result of both demographic and epidemiologic transitions happening in the country. The prevalence of obesity in Nigeria increased from 3% to 8.1% in 2010-8.1% and 22.2% in 2013, an increase of more than two times between 2010 and 2013. The prevalence of obesity among individuals aged 30 years and above increased by 47% and 39% in men and women, respectively, between 2002 and 2010 in Nigeria.,,,
Obesity is a noncommunicable medical disorder that has been largely accepted as a reflection of healthy living and affluence among Nigerians. It is a desirable trait in the country, as many Nigerians have a positive perception of large body size. It is a modifiable cardiovascular risk factor which predisposes to and occurs in combination with other NCD such as diabetes mellitus, hypertension, dyslipidemia, and metabolic syndrome,,,
The ability to diagnose obesity by clinicians is an opportunity to counsel patients on lifestyle modification and screen them for obesity-related morbidities. The rising burden of obesity and other related co-morbidities in developing countries including Nigeria formed the basis for this study.
| Methodology|| |
The retrospective study was carried out in the dietetics outpatient clinic of Babcock University Teaching Hospital Ilisan-Remo Ogun state. This Teaching Hospital provides medical facilities to people in and outside the state. The records of patients that attended the dietician's clinic were used. The information retrieved includes individual's age, weight, height, body mass index (BMI), and diagnosed diseases. Required information about individuals was entered in a case report form this form served as the primary source of data for statistical analysis. The study covered a period of 75 months, from January 2015 to March 2021.
Using the WHO classification, obesity (≥30 kg/m2) was categorized as: Class one (BMI = 30.0 − 34.9), class two (BMI = 35.0–39.9), and class three (BMI ≥40). Hypertension (systolic blood pressure >140 and diastolic blood pressure >90) and diabetes (fasting plasma glucose ≥7.0 mmol/l [126 mg/dl] or 2–h plasma glucose ≥11.1 mmol/l [200 mg/dl]).
All statistical analyses were performed using the Statistical Package for Social Sciences (SPSS) version 20.0. Continuous variables were given as mean ± standard deviation and categorical variables as frequency/percentage in each subgroup. For associations between categorical variables, the Chi-square test was used. All statistical analyses were two-tailed and were set at a 5% level of significance P < 0.05.
| Results|| |
A total of 1059 patients' records were used. The ages of the respondents ranged from 15 to 92 years with a mean age of 35 ± 18.8 years. Sex distribution shows males making up 37.2% and females 62.8%. The mean weights of both male and female patients were fairly comparable (P < 0.05), with the males having slightly higher mean weight (M = 91.3 kg ± 23.7, F = 86.6 ± 22.2). The mean height for males was significantly higher than that of the females (M = 1.7 ± 0.08 m, F = 1.62 ± 0.06 m, P < 0.05). The mean BMI for females (32.5 ± 7.79 kg/m2) was significantly higher (P < 0.05) than the males (31.2 ± 7.32). The overall prevalence of obesity was 58.9%, the prevalence was significantly higher among women (P < 0.05). Those that had mild obesity (26.3%) were the most represented, with 10.6% of them being males and 15.7% being females. The prevalence of severe obesity (BMI ≥ 40) was 14.5%.
More than half 60.3% had normal blood pressure, 2.3% had prehypertension (males: 1%, females: 1.2%) and 37.4% had hypertension (males: 19%, females: 18.4%). About 18.9% of them were diabetic, with 13.5% having Type 2 diabetes (M = 6.5%, F = 7%) and 4.9% prediabetic [Table 1] and [Table 2].
|Table 1: Gender-specific distribution of parameters (body mass index, blood pressure, blood glucose)|
Click here to view
The highest prevalence of overweight was seen among patients aged 15–29 years and obesity was also highest among the same age group. The age group with the lowest prevalence of overweight was 40–49 years and obesity ≥60 years. Hypertension (systolic blood pressure >140 and diastolic blood pressure >90) and diabetes (fasting plasma glucose ≥7.0 mmol/l (126 mg/dl) or 2–h plasma glucose ≥11.1 mmol/l (200 mg/dl)) were higher among patients aged 60 and above, while age group 30–39 years has the lowest prevalence. Diabetes also increased with age [Table 3].
|Table 3: Age distribution of parameters (body mass index, blood pressure, and blood glucose)|
Click here to view
BMI was significantly associated with hypertension (P < 0.05). Out of 37.4% of participants who had hypertension, 9.2% were overweight and 23.9% of them were obese. Age was also significantly associated (P < 0.05) with hypertension as hypertension was higher among the age group 18–29 years and 50 and above. There was a significant association between gender and hypertension (P = 0.00), it was prevalent among males 19.1% than females 18.4% [Table 4].
|Table 4: Association between body mass index, gender, age, hypertension, and diabetes|
Click here to view
A significant association was found between obesity and age (P < 0.05). Obesity was higher among the younger age group than the older. There was a significant association between obesity and gender (P < 0.05) as obesity was prevalent among females than males [Table 5].
BMI was significantly associated with diabetes (P < 0.05), out of the 18.5% of the patients who were diabetic 6.5% and 8.7% of them were overweight and obese. Majority of those who were diabetic were 40 years and above. Gender was significantly associated with diabetes (P < 0.05) as diabetes occurred more among females 10.1% than males 8.8%. A significant association was also found between hypertension and diabetes (P < 0.05), as out of 18.8% of patients that had diabetes, 11.1% had hypertension [Table 4] and [Table 6].
| Discussion|| |
There were more females than males in our studied sample, a finding that is consistent with a study by Ogbera et al. in Lagos, Southwest Nigeria, other studies also reported same-gender disparities.,,,
Prevalence of obesity
This study recorded high prevalence of obesity of 58.9%, of which 14.5% had BMI >40 kg/m2. This prevalence rate is higher than the 27.4% prevalence rate reported by Gazenwa et al. in a study among Type 2 Diabetes at a Tertiary Healthcare Center in Northern Nigeria and the 13.7% reported by Adamu et al. in a study among a sampled population in Sokoto Nigeria but lower than the 74% reported by Olatona et al. in a study among diabetic patients in Lagos. Other studies also reported a relatively high prevalence rates in some regions both within and outside Nigeria However, the prevalence rate in this present study is higher than those in the studies.,,, These relatively high prevalence rates of obesity both in Nigeria and other regions of the world show that obesity is fast becoming a global health problem.
Obesity in this study was prevalent among females than males. Other studies among individuals with or without hypertension and diabetes have reported similar gender disparity in the prevalence of obesity.,, The higher obesity rate among females may be attributed to short intervals between pregnancies, hormonal imbalance related to menopause, use of oral contraceptive pills, dietary habit, and sedentary lifestyles.
Interestingly, Obesity was found to be prevalent among patients between the ages of 15 and 29 years and prevalence was lowest among the elderly aged 60 years and above, deducing that adolescents and young adults are presently becoming more obese, further studies is needed to ascertain the factors responsible for the increase in the prevalence of obesity among these age group and interventions on reducing the prevalence of obesity in the society should be geared toward adolescents and young adults between the ages of 15 and 30 years and women especially those within the reproductive age group.
Prevalence of hypertension
The prevalence of hypertension in this study which is 37.4% is higher than the 27% reported by Gazenwa et al. in a study among Type 2 Diabetes at a Tertiary Healthcare Center in Northern Nigeria, 30.6% reported by Adamu et al. in a study among a sampled population in Sokoto Nigeria but lower than the 51.3% reported by oforia and obosi in a study among office workers in a multi-national company in the Niger-Delta Nigeria and 48.9% in a review study of hypertension in Nigeria by Akinlua et al. Hypertension in this study was prevalent among males than females which is consistent with the report from studies study by Adeloye et al., Akinlua et al., and Ebirim et al.,, however, Adamu et al. reported hypertension to be higher among females than males in his study.
Studies have reported hypertension to be prevalent among older adults,, however, in this study; hypertension was prevalent among adolescents and young adults within age 15–29 years. This finding is consistent with the report in a study by Wordu et al. on dietary intake and prevalence of adolescent hypertensive in Port-Harcourt Nigeria and Ukegbu et al. on obesity and associated factors in young adults attending tertiary institutions in south-eastern Nigeria where hypertension was prevalent among adolescents and young adults, respectively.
A significant association exists between hypertension and obesity (P < 0.05) and several studies also reported similar finding., Obesity was high among patients <29 years and hypertension was also high among the same age group Wordu et al. and Ukegbu et al. also reported a similar finding where both hypertension and obesity were high among adolescents and young adults. The high prevalence of obesity among these adolescents and young adults may be the causal factor in the development of hypertension among them. This calls for a critical look into holistic strategies aiming at the prevention and treatment of obesity-related hypertension among adolescents and young adults.
Prevalence of diabetes
This study recorded a high prevalence of diabetes at 18.9%. The prevalence of Type 2 diabetes which is 13.5% is higher than 4.6% reported by Shittu et al. in a study on the prevalence of diabetes and prediabetes in the Oke-Ogun region of Oyo state but lower than the 20.8% in a study in Sudan and 34.6% in a study in Semi-Urban Saudi Arabia by Mansour et al. Prediabetes and diabetes were found to increase with age, most occurring among the elderly and gestational diabetes was found only among women between the ages 30 and 39 years. Other studies also reported diabetes to be prevalent among older adults,, with the prevalence increasing as age increases. In some studies, women were reported to have Type 2 diabetes than men,, which is consistent with this study as Type 2 diabetes was found among women than men.
The association between obesity and diabetes was significant (P < 0.05), which revealed obesity as an important determinant of diabetes as reported in previous studies., It has been well established that diabetes is a risk factor for hypertension and vice versa., Majority of those who had diabetes also had hypertension.
| Conclusion|| |
The prevalence of obesity, hypertension, and diabetes was high in this study. Obesity and hypertension were well known to be prevalent among older adults, but in this study, it was found to be prevalent among adolescents and young adults. Obesity was also associated with hypertension and diabetes. The development of strategies to prevent and treat obesity and obesity-related hypertension among young adults is needed.
Limitations of the study
All respondents were identified from a single affiliation, and they were all seeking health care services thus possibly were not representative of the broader southwestern population.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
WHO. Global Status Report on Noncommunicable Diseases 2010. Geneva: WHO; 2011.
Islam SM, Purnat TD, Phuong NT, Mwingira U, Schacht K, Fröschl G. Non-communicable diseases (NCDs) in developing countries: A symposium report. Global Health 2014;10:81.
Khorrami Z, Etemad K, Yarahmadi S, Khodakarim S, Kameli M, Hezaveh AM, et al.
Urbanization and noncommunicable disease (NCD) risk factors: WHO STEPwise Iranian NCD risk factors surveillance in 2011. East Mediterr Health J 2017;23:469-79.
Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: Global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract 2011;94:311-21.
Lago RM, Singh PP, Nesto RW. Diabetes and hypertension. Nat Clin Pract Endocrinol Metab 2007;3:667.
Sacco RL, Smith SC, Holmes D, Shurin S, Brawley O, Cazap E, et al.
Accelerating progress on non-communicable diseases. Lancet 2013;382:e4-5.
Kankeu HT, Saksena P, Xu K, Evans DB. The financial burden from non-communicable diseases in low- and middle-income countries: A literature review. Health Res Policy Syst 2013;11:31.
Kengne AP, Mayosi BM. Readiness of the primary care system for noncommunicable diseases in sub-Saharan Africa. Lancet Glob Health 2014;2:e247-8.
Maher D, Sekajugo J. Research on health transition in Africa: Time for action. Health Res Policy Syst 2011;9:5.
Panda R, Mahapatra S, Persai D. Health system preparedness in noncommunicable diseases: Findings from two states Odisha and Kerala in India. J Family Med Prim Care 2018;7:565-70.
] [Full text]
Chukwuonye II, Chuku A, John C, Ohagwu KA, Imoh ME, Isa SE, et al
. Prevalence of overweight and obesity in adult Nigerians – A systematic review. Diabetes Metab Syndr Obes 2013;6:43-7.
Ono T, Guthold R, Strong K. WHO Global Comparable Estimates: Global Infobase Data for Saving Lives 2005. World Health Organization. WHO (2012) Fact Sheet on Obesity 2010, World Health Organisation; 2012.
Chibuike C. Epidemiology of Adult Obesity in Enugu Southeast Nigeria. Doctoral Thesis, for the Awarding of a Doctor of Philosophy (Ph.D.) at the Medical Faculty of Ludwig-Maximilians-Universität, Munich; 2018.
Amira CO, Sokunbi DO, Sokunbi A. The prevalence of obesity and its relationship with hypertension in an urban community: Data from world kidney day screening programme. Int J Med Biomed Res 2012;1:104-10.
Chukwu CE, Ebuehi OA, Ajuluchukwu JN, Olashore AH. Anthropometric, socio-demographic and biochemical risk factors of hypertension in Lagos, Nigeria. Alex J Med 2021;57:44-51.
Odeyinka OT, Ajayi IO. Prevalence of hypertension and diabetes and their determinants among commercial drivers in Ibadan metropolis, South-Western Nigeria. Nig J Cardiol 2017;14:75-83. [Full text]
Gezawa ID, Puepet FH, Mubi BM, Uloko AE, Bakki B, Talle MA, et al
. Prevalence of overweight and obesity in Maiduguri, Northeastern Nigeria. Niger J Med 2013;22:171-4. [Full text]
Sabir AA, Balarabe S, Sani AA, Isezuo SA, Bello KS, Jimoh AO, et al.
Prevalence of diabetes mellitus and its risk factors among the suburban population of Northwest Nigeria. Sahel Med J 2017;20:168-72. [Full text]
Ogbera AO. Prevalence and gender distribution of the metabolic syndrome. Diabetol Metab Syndr 2010;2:1.
Atiba AS, Oparinde DP, Akande JO, NIran-Atiba TA, Bello NO. Obesity and hypertension among Nigerians with impaired fasting glucose. Pak J Nutr 2020. [doi: 10.3923/pjn. 2020.266.270].
Omar SM, Musa IR, ElSouli A, Adam I. Prevalence, risk factors, and glycaemic control of type 2 diabetes mellitus in eastern Sudan: A community-based study. Ther Adv Endocrinol Metab 2019;10:2042018819860071.
Aniedi UV, Ekong AE, Idung A. Hypertension among type 2 diabetic patients in Uyo, South East Nigeria. J Adv Med Med Res 2018;26:1-6.
Olatona FA, Airede CA, Aderibigbe SA, Osibogun A. Nutritional knowledge, dietary habits and nutritional status of diabetic patients attending teaching hospitals in Lagos. J Community Med Prim Health Care 2019;31:90-103.
Gezawa ID, Uloko AE, Gwaram BA, Ibrahim DA, Ugwu ET, Mohammed IY. Pattern of obesity among patients with type 2 diabetes at a tertiary healthcare center in Northern Nigeria. Diabetes Metab Syndr Obes 2019;12:2785-90.
Adamu H, Makusidi AM, Liman HM, Isah MD, Jega MR, Chijioke A. Prevalence of obesity, diabetes type 2 and hypertension among a sampled population from Sokoto Metropolis-Nigeria. Br J Med Med Res 2014;4:2065-80.
Price AJ, Crampin AC, Amberbir A, Kayuni-Chihana N, Musicha C, Tafatatha T, et al.
Prevalence of obesity, hypertension, and diabetes, and cascade of care in sub-Saharan Africa: A cross-sectional, population-based study in rural and urban Malawi. Lancet Diabetes Endocrinol 2018;6:208-22.
Ekpenyong CE, Udokang NE, Akpan EE, Samson TK. Double burden, non-communicable diseases and risk factors evaluation in Sub-Saharan Africa: The Nigerian experience. Eur J Sustain Dev 2012;1:249-70.
Olebu J, Ajaebili NA, Maduforo AN. Assessment of prevalence of obesity among newly diagnosed type 2 diabetic patients in diabetic out patient clinic, of University of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla, Enugu State, Nigeria. Adv Life Sci Technol 2014;24:60-4.
Adienbo OM, Hart VO, Oyeyemi WA. High prevalence of obesity among indigenous residents of a Nigerian ethnic group: The Kalabaris in the Niger delta region of South-South Nigeria. Green J Med Sci 2012;2:152-6.
Oforia SN, Obosib J. Prevalence of hypertension among office workers in a multi-national company in the Niger-Delta with the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline. Prev Med Rep 2019;15:100899.
Akinlua JT, Meakin R, Umar AM, Freemantle N. Current prevalence pattern of hypertension in Nigeria: A systematic review. PLoS One 2015;10:e0140021.
Adeloye D, Baquill C, Aderemi AV, Thompson JY, Obi FA. An estimate of the prevalence of hypertension in Nigeria. J Hypertens 2014. [doi: 10.1097/HJH.0000000000000413].
Ebirim CI, Udujih OG, Dozie UW, Agbaka CA, Orji SM. Prevalence of hypertension among adults aged 40 years and above in Ahiazu Mbaise, Imo State, Nigeria. Arch Community Med Public Health 2018;4:013-6.
Ajayi IO, Sowemimo IO, Akpa OM, Ossai NE. Prevalence of hypertension and associated factors among residents of Ibadan-North Local Government Area of Nigeria. Nig J Cardiol 2016;13:67-75. [Full text]
Osunkwo D, Mohammed A, Kamateeka M, Nguku P, Umeokonkwo CD, Abolade OS, et al.
Population-based prevalence and associated risk factors of hypertension among adults in Benue State, Nigeria. Niger J Clin Pract 2020;23:944-9.
] [Full text]
Zhang Y, Hou LS, Tang WW, Xu F, Xu RH, Liu X, et al
. High prevalence of obesity-related hypertension among adults aged 40 to 79 years in Southwest China. Sci Rep 2019;9:15838.
Wordu GO, Wachukwu-Chikodi HI. Dietary intake and prevalence of adolescent hypertensive in Port Harcourt, Nigeria. Int J Res Granthaalayah 2019;7:22-9.
Ukegbu PO, Uwaegbute AC, Echendu CA, Ejike C, Anyika-Elekeh JU, Asumugha VU, et al.
Obesity and associated factors in young adults attending tertiary institutions in south-eastern Nigeria. S Afr J Clin Nutr 2017;30:43-8.
Shittu RO, Kasali FO, Biliaminu SA. Prevalence of diabetes and pre-diabetes in OkeOgun Region of Oyo State, Nigeria. J Med Res Health Educ 2017;1:1.
Al Mansour MA. The prevalence and risk factors of type 2 diabetes mellitus (DMT2) in a semi-urban Saudi population. Int J Environ Res Public Health 2019;17:7.
Aladeniyi I, Adeniyi OV, Fawole O, Adeolu M, Goon DT, Ajayi AI, et al
. The prevalence and correlates of pre-diabetes and diabetes mellitus among public category workers in Akure, Nigeria. Open Public Health J 2017;10. Available from: https://DOI: 10.2174/1874944501710010167
Joseph-Shehu EM, Ncama BP. Evaluation of health status and its predictor among university staff in Nigeria. BMC Cardiovasc Disord 2018;18:183.
Colussi G, Da Porto A, Cavarape A. Hypertension and type 2 diabetes: Lights and shadows about causality. J Hum Hypertens 2020;34:91-3.
Idris IO, Oguntade AS, Mensah EA, Kitamura N. Prevalence of non-communicable diseases and its risk factors among Ijegun-Isheri Osun residents in Lagos State, Nigeria: A community based cross-sectional study. BMC Public Health 2020;20:1258.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]