Age-Dependent Influence of Gender on the Association Between Obesity and a Cluster of Cardiometabolic Risk Factors

Abstract

Obesity is a main risk factor in metabolic syndrome. Gender is known to influence the risk of obesity and other cardiovascular risk factors. However, it remains to be determined whether there is a gender-specific difference in the relationship between obesity and accumulation of other cardiometabolic risk factors such as hypertension, dyslipidemia, and diabetes. The aim of this study was to determine whether the association between obesity and a cluster of other cardiometabolic risk factors is modified by gender. The subjects were 17,791 Japanese men and women who were divided into younger (35-40 years) and older (60-70 years) age groups. The relationships between obesity (body mass index [BMI] ≥25 kg/m(2) or waist-to-height ratio [WHtR] ≥0.5) and multiple cardiometabolic risk factors (≥2 of the risk factors of high blood pressure, dyslipidema, and hyperglycemia) were compared between men and women in each age group. In the younger group, the crude odds ratios (ORs) for multiple cardiometabolic risk factors in obese versus nonobese subjects were significantly higher in women than in men (BMI: 6.23 [range, 5.53-7.02] in men vs 16.63 [range, 12.37-22.37] in women, P < 0.01; WHtR: 6.04 [range, 5.36-6.81] in men vs 9.77 [range, 7.14-13.37] in women, P < 0.01), whereas this difference was not found in the older group (BMI: 3.03 [range, 2.69-3.42] in men vs 2.92 [range, 2.33-3.67] in women P = 0.076; WHtR: 3.11 [range, 2.78-3.47] in men vs 2.50 [range, 2.02-3.09] in women, P < 0.05). On multivariate logistic regression analysis, the ORs for multiple cardiometabolic risk factors after adjusting for age, smoking, alcohol consumption, and regular exercise in subjects with versus subjects without a large waist circumference tended to be higher in women than in men in the younger group but not in the older group. The ORs of the interaction term consisting of gender and each adiposity index for multiple cardiometabolic risk factors were significantly higher than a reference level of 1.00 in the younger group (BMI: 2.68 [range, 1.95-3.69], P < 0.01; WHtR: 1.62 [range, 1.16-2.27], P < 0.01) but not in the older group (BMI: 0.95 [range, 0.74-1.23], P = 0.712; WHtR: 0.80 [range, 0.63-1.02], P = 0.066). The results suggest that the association between obesity and a cluster of cardiometabolic risk factors is stronger in women than in men, and this gender-specific difference exists in younger (35-40 years) but not in older (60-70 years) individuals.