Cardiometabolic comorbidities across obesity classes among adults attending a general outpatient clinic in South-South Nigeria: a hospital-based cross-sectional study

Abstract

Background: Obesity is strongly associated with hypertension, diabetes mellitus, dyslipidaemia, and metabolic syndrome, but the burden and distribution of these conditions vary by population and care setting. Evidence from semi-urban outpatient populations in South-South Nigeria remains limited. This study assessed cardiometabolic comorbidities among adults with obesity attending a general outpatient clinic and examined their distribution across obesity classes. Methods: A hospital-based cross-sectional study included 300 adults aged 18 years or older with body mass index (BMI) >=30 kg/m2 who attended the General Outpatient Department of Irrua Specialist Teaching Hospital, Edo State, Nigeria, between February and May 2024. Participants were selected using systematic sampling. Sociodemographic and clinical data, anthropometric indices, blood pressure, fasting plasma glucose, and fasting lipid measurements were obtained. Categorical variables were summarised as frequencies and percentages, with Wilson 95% confidence intervals (CIs) for principal prevalence estimates. Associations between obesity class and cardiometabolic outcomes were assessed using Pearson chi-square tests. Results: The mean age was 51.6 +/- 8.9 years, and 215 participants (71.7%) were women. Class I obesity was most frequent (194/300, 64.7%), followed by Class II (79/300, 26.3%) and Class III (27/300, 9.0%). Hypertension affected 250 participants (83.3%; 95% CI 78.7-87.1), dyslipidaemia 158 (52.7%; 47.0-58.2), diabetes mellitus 98 (32.7%; 27.6-38.2), and metabolic syndrome 79 (26.3%; 21.7-31.6). Obesity class was associated with hypertension (chi-square=8.91, p=0.012), metabolic syndrome (chi-square=32.58, p<0.001), dyslipidaemia (chi-square=7.12, p=0.028), total cholesterol >=200 mg/dL (chi square=10.76, p=0.005), and triglycerides >=150 mg/dL (chi-square=31.16, p<0.001). Diabetes mellitus and HDL cholesterol were not significantly associated with obesity class. Conclusion: Cardiometabolic comorbidities were common in this selected outpatient population with obesity. Metabolic syndrome and raised triglycerides increased markedly across obesity classes, whereas other associations were non-linear. Routine, integrated cardiometabolic assessment should accompany obesity care in general outpatient practice. The cross sectional, hospital-based design and unresolved lipid-coding details require cautious interpretation.