Population burden of diabetes, hypertension, and cardiovascular disease attributable to obesity: a community-based study in Türkiye

Abstract

Obesity has emerged as a global public health pandemic, with rapidly increasing prevalence and a growing burden of obesity-related chronic diseases worldwide. Despite its high prevalence, obesity remains underdiagnosed, limiting effective prevention and management. Reliable, region-specific epidemiological data are therefore essential to guide public health interventions and policy development. This study aimed to examine the prevalence of obesity and its associations with chronic diseases across different age and sex groups in the community. The study included adults residing in Amasya, northern Türkiye. Data were collected at field booths between 15 June and 31 July 2025. Height and weight were measured using standardized procedures, while chronic diseases were self-reported. Associations of obesity with diabetes, hypertension, and cardiovascular disease were assessed using age- and sex-adjusted logistic regression, including interaction analyses. Attributable measures were also calculated. The study included 22,667 adults (50.6% women), with a mean age of 46.4 ± 16.1 years. The prevalence of obesity was 29.9% and was higher among women than men (35.7% vs. 23.9%). The prevalences of diabetes mellitus, hypertension, and cardiovascular disease were 12.1, 16.2, and 6.6%, respectively, and were substantially higher among individuals with obesity than among those without obesity. After adjustment for age and sex, obesity was associated with higher odds of diabetes mellitus [adjusted odds ratio (aOR) = 2.88, 95% CI 2.65–3.14], hypertension (aOR = 2.50, 95% CI 2.31–2.70), and cardiovascular disease (aOR = 2.29, 95% CI 2.05–2.56). The adjusted population attributable fractions of obesity were 31.5% for diabetes mellitus, 25.8% for hypertension, and 26.1% for cardiovascular disease. Age significantly modified the associations between obesity and all three chronic conditions, whereas no significant interaction with sex was observed. This community-based study demonstrates that obesity is highly prevalent and strongly associated with DM, HT, and CVD. The substantial population-level burden of these conditions statistically attributable to obesity further underscores its importance as a major public health problem. These findings support strengthening evidence-based strategies that promote healthy weight through lifestyle modification and population-based prevention approaches.