Cardiometabolic multimorbidity (CMM) is one of the most common patterns of co-morbidity aggregated in middle-aged and older adults. It greatly increases the risk of disability and death in our country. Insulin resistance and obesity are closely related to the occurrence and development of cardiometabolic diseases (CMD). The correlation between obesity and various types of CMD has been previously confirmed. The risk of CMM in residents with varying types of obesity and gender may be different and still unclear.

To identify the correlation of the type of obesity and CMM in male and female middle-aged residents in Anhui Province.

The subjects of this study were derived from the Early Screening and Comprehensive Intervention Program for People at High Risk of Cardiovascular Disease carried out in Anhui Province from 2017 to 2021, with a total of 10 project sites involving community residents in 12 counties and cities. Finally, 70 812 permanent middle-aged residents (45-<65 years) were included. Surveying of the subjects was performed by pre-trained investigators, including the general information (age, gender, smoking, alcohol consumption, remarriage education level of high school and above, farmers), disease history (hypertension, heart disease, diabetes, stroke, dyslipidemia), physical examination (height, body mass index, waist circumference), and laboratory tests (blood glucose, blood lipids). Subjects were divided into male and female, and sub-divided into non-obese, peripheral obesity, central obesity, and compound obesity. Logistic regression analysis was conducted to explore the correlation of CMM with gender and type of obesity. The effect value in male and female groups with different types of obesity was compared by the Z-test in R package.

A total of 26 726 male and 44 086 female residents were included. The prevalence of CMM in the total population, male and female groups was 14.6% (10 361/70 812), 16.6% (4 445/26 726), and 13.4% (5 916/44 086), respectively. The prevalence of hypertension, diabetes mellitus, heart disease, stroke, and dyslipidemia among middle-aged residents of Anhui Province was 27.0%, 7.8%, 0.5%, 2.5%, and 29.5%, respectively. Logistic regression analysis showed that, after adjusting for age, smoking, alcohol consumption, remarriage, education level of high school and above, and occupation of farmers, the risk of CMD significantly increased in the peripheral obesity (OR=1.665, 95% CI=1.599-1.734), central obesity (OR=1.788, 95% CI=1.656-1.930), and compound obesity subgroups (OR=3.020, 95% CI=2.913-3.131) than the non-obesity subgroup (P<0.05). In either the male or female group, the risk of CMM increased sequentially in the peripheral obesity, central obesity, and compound obesity subgroups. In the male group, the OR (95%CI) of an increased risk of CMM in peripheral obesity, central obesity, and compound obesity subgroups compared to the non-obese subgroups was 2.008 (1.822-2.213), 2.281 (1.875-2.774), and 4.137 (3.799-4.504), respectively; while in the female group, it was 1.574 (1.443-1.717), 1.727 (1.509-1.976), and 2.916 (2.721-3.126), respectively (P<0.05). The Z-test results showed a significant difference among the peripheral obesity, central obesity, and compound obesity subgroups in male and female residents (P<0.05). After adjusting for the blood lipids and other related indexes, the risk of CMM in the peripheral obesity, central obesity, and compound obesity subgroups in male and female residents increased sequentially with a significant difference (P<0.05). Z-test showed a significant difference in the risk of CMM in the compound obesity subgroup of male and female residents (Z=2.258, P<0.05) .

The risk of CMM varies in middle-aged residents of Anhui Province with different types of obesity, showing the highest risk in those with compound obesity, followed by central obesity. Male middle-aged residents with compound obesity have a higher risk of CMM than females, serving as a highly concerned population.