Nigerian Journal of Cardiology

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 18  |  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

Correspondence Address:
Ms. Adeola Beatrice Adetola
Department of Dietetics, Babcock University Teaching Hospital, Ilisan-Remo, Ogun State
Nigeria

Abstract

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.



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;18:51-56


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 Feb 6 ];18:51-56
Available from: https://www.nigjcardiol.org/text.asp?2021/18/2/51/363143


Full Text



 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.[1] 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[1] with globalization, rapid urbanization, westernization, and nutrition transition contributing to the surge.[2],[3],[4] As of 2011, there were 366 million people living with diabetes mellitus and this is expected to rise to 522 million by 2030.[5] Over 600 million people are currently hypertensive and this figure is predicted to increase to 1.56 billion people by the year 2025.[6],[7] 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.[8],[9],[10],[11]

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.[12] 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.[13],[14],[15],[16]

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.[17] 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[18],[19],[20],[21]

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,[1] 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}{Table 2}

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}

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}

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].{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].{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,[22] other studies also reported same-gender disparities.[23],[24],[25],[26]

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[27] and the 13.7% reported by Adamu et al. in a study among a sampled population in Sokoto Nigeria[28] but lower than the 74% reported by Olatona et al. in a study among diabetic patients in Lagos.[26] 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.[17],[18],[29],[30] 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.[30],[31],[32] 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.[31]

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,[27] 30.6% reported by Adamu et al. in a study among a sampled population in Sokoto Nigeria[28] 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[33] and 48.9% in a review study of hypertension in Nigeria by Akinlua et al.[34] 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.[34],[35],[36] however, Adamu et al.[28] reported hypertension to be higher among females than males in his study.

Studies have reported hypertension to be prevalent among older adults[37],[38],[39] 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[40] and Ukegbu et al. on obesity and associated factors in young adults attending tertiary institutions in south-eastern Nigeria[41] 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.[37],[38] Obesity was high among patients <29 years and hypertension was also high among the same age group Wordu et al.[40] and Ukegbu et al.[41] 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[42] but lower than the 20.8% in a study in Sudan[24] and 34.6% in a study in Semi-Urban Saudi Arabia by Mansour et al.[43] 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,[44],[45] with the prevalence increasing as age increases. In some studies, women were reported to have Type 2 diabetes than men,[43],[45] 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.[23],[44] It has been well established that diabetes is a risk factor for hypertension and vice versa.[46],[47] 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

Nil.

Conflicts of interest

There are no conflicts of interest.

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