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cross-sectional·epidemiology, public health, endocrinology, cardiology, internal medicine·PMC10649606

Unveiling the effects of living standards on diabetes and hypertension with the mediating role of overweight and obesity: a cross-sectional study in Bangladesh

BMJ Open · 4 authors, 1 centre

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This cross-sectional study analyzed data from the 2017–2018 Bangladesh Demographic and Health Survey to examine how household living standard (LSD) is associated with diabetes and hypertension, both directly and indirectly through BMI as a mediator. Using structural equation modeling and logistic regression, the study found that individuals with high LSD had significantly higher odds of having diabetes (OR 2.22), hypertension (OR 1.25), or both conditions (OR 2.48) compared to those with low LSD. The indirect effects of high LSD through obesity were greater than the direct effects for developing these conditions. The findings suggest that public health interventions should promote physical activity and weight management alongside improving living standards to mitigate the rising risk of these chronic diseases.

STUDY TYPE

cross-sectional

SPECIALTY

epidemiology

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ORIGINAL PAPER

PMC10649606

Unveiling the effects of living standards on diabetes and hypertension with the mediating role of overweight and obesity: a cross-sectional study in Bangladesh

BMJ Open

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ABSTRACT

Objective The purpose of the study was to ascertain how the standard of living is associated with the likelihood of developing diabetes and hypertension directly as well as indirectly through overweight and obesity. Study design The study used 2017–2018 Bangladesh Demographic and Health Survey data. It examined the household living standard (LSD) as the main factor, and body mass index (BMI) as a mediator. Outcomes included diabetes status, hypertension status and their co-occurrence. Structural equation modelling with logistic regression and bootstrapping were used for mediation analysis and computing bias-corrected SEs. Setting The research was carried out in Bangladesh and included both male and female adults. Participants The study encompassed a total of 11 961 adults (5124 males and 6837 females) aged 18 years or older. Results Among the participants, 10.3% had diabetes, 28.6% had hypertension and 4.9% had both conditions. The prevalence of diabetes, hypertension or both conditions was 18.5%, 33.5% and 9.7%, respectively, among those with a high LSD. Regression analysis demonstrated that individuals with high LSD had significantly elevated risks of these conditions compared with those with low LSD: 133% higher odds for diabetes (OR 2.22; 95% CI 1.97 to 2.76), 25% higher odds for hypertension (OR 1.25; 95% CI 1.10 to 1.42) and 148% higher odds for both conditions (OR 2.48; 95% CI 1.96 to 3.14). Moreover, the indirect effects of high LSD through obesity surpassed its direct effects for developing diabetes, hypertension or both conditions. Conclusion This study emphasises that with the enhancement of LSD, individuals often experience weight gain, resulting in elevated BMI levels. This cascade effect significantly amplifies the risks of diabetes, hypertension or both conditions. To counteract this concerning trajectory, policy interventions and targeted awareness campaigns are imperative. These efforts must prioritise the promotion of heightened physical activity and the mitigation of the overweight/obesity surge associated with rising LSD.

CITATION EXPORT

Kanchan Kumar Sen, Ahsan Rahman Jamee, Ummay Nayeema Islam et al.. Unveiling the effects of living standards on diabetes and hypertension with the mediating role of overweight and obesity: a cross-sectional study in Bangladesh. BMJ Open. (2023). https://doi.org/10.1136/bmjopen-2023-075370

AUTHORS

4 · 1 CENTRES

Kanchan Kumar Sen, Ahsan Rahman Jamee, Ummay Nayeema Islam, Wasimul Bari

Department of Statistics, University of Dhaka, Dhaka, Bangladesh