CONTEXT There is limited knowledge about the disparities between the sexes in obesity prevalence and associated cardiovascular complications in low- and middle-income countries (LMICs). OBJECTIVE We undertook a systematic review and meta-analysis to assess sex-specific disparities in the prevalence of obesity and cardiometabolic diseases in LMICs, the burden in women, and variations by region, country's income status, setting, and time. METHODS We searched major databases from inception to March 2023. Two independent reviewers selected the studies, assessed their quality, and extracted data. We used DerSimonian and Laird random-effects models to obtain pooled estimates of odds ratios and 95% CI for the association between sex and obesity and cardiometabolic diseases, and multilevel random-effects logistic regression models to estimate the prevalence of relevant outcomes (PROSPERO CRD42019132609). RESULTS We included 345 studies (3 916 276 individuals). The odds of obesity were 2.72-fold higher in women than men (OR 2.72; 95% CI, 2.54-2.91). The sex-specific disparities varied by region, with the greatest disparities in Sub-Saharan Africa (OR 3.91; 95% CI, 3.49-4.39). Among women in LMICs, 23% (95% CI, 21%-25%) had obesity, 27% (95% CI, 24%-29%) had hypertension, and 7% (95% CI, 6%-9%) had type 2 diabetes. The prevalence of obesity and type 2 diabetes in women varied by region, country's income, and setting, with the highest prevalence in the Middle East and North Africa, upper-middle-income countries and urban settings. The odds of hypertension (OR 2.41; 95% CI, 1.89-3.08) and type 2 diabetes (OR 2.65; 95% CI, 1.76-3.98) were doubled in women with vs without obesity. CONCLUSION There is an urgent need for a women-centred and region-stratified approach to tackle obesity awareness, treatment, and prevention in women in LMICs.

中文翻译：

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低收入和中等收入国家的特定性别肥胖和心脏代谢疾病风险：涉及 3 916 276 名个人的荟萃分析。

背景 对于低收入和中等收入国家 (LMIC) 中肥胖患病率和相关心血管并发症的性别差异，人们知之甚少。目的 我们进行了系统回顾和荟萃分析，以评估中低收入国家肥胖和心脏代谢疾病患病率的性别差异、女性的负担以及地区、国家收入状况、环境和时间的差异。方法 我们检索了从开始到 2023 年 3 月的主要数据库。两名独立评审员选择了这些研究，评估了它们的质量并提取了数据。我们使用 DerSimonian 和 Laird 随机效应模型来获得性别与肥胖和心脏代谢疾病之间关联的比值比和 95% CI 的汇总估计值，并使用多级随机效应逻辑回归模型来估计相关结果的发生率 (PROSPERO CRD42019132609) 。结果 我们纳入了 345 项研究（3 916 276 人）。女性肥胖的几率是男性的 2.72 倍（OR 2.72；95% CI，2.54-2.91）。性别差异因地区而异，其中撒哈拉以南非洲地区的差异最大（OR 3.91；95% CI，3.49-4.39）。在中低收入国家的女性中，23% (95% CI, 21%-25%) 患有肥胖症，27% (95% CI, 24%-29%) 患有高血压，7% (95% CI, 6%-9%) 患有高血压）患有2型糖尿病。女性肥胖和 2 型糖尿病的患病率因地区、国家收入和环境而异，中东和北非、中高收入国家和城市环境的患病率最高。与非肥胖女性相比，肥胖女性患高血压（OR 2.41；95% CI，1.89-3.08）和 2 型糖尿病（OR 2.65；95% CI，1.76-3.98）的几率增加了一倍。结论 迫切需要采取以妇女为中心、按地区分层的方法来解决中低收入国家妇女的肥胖意识、治疗和预防问题。