Obesity grade I: a study of real clinical practice in the Russian Federation

ABSTRACT

Objective. To evaluate current approaches to the treatment of obesity grade I in the Russian Federation and associated risks of arterial hypertension, type 2 diabetes mellitus, dyslipidemia, cardiovascular events (myocardial infarction and stroke) considering real clinical practice data.

Material and methods. We performed an observational retrospective study using «Webiomed» predictive analytics platform contained anonymized electronic records of patients from medical information systems of various hospitals and regions of the Russian Federation between 1999 and 2022. We assessed 10-year risk of hypertension, type 2 diabetes, dyslipidemia, and cardiovascular events (myocardial infarction and stroke) in 59,427 patients aged 18—50 years with obesity grade I. We studied treatment approaches for obesity grade I and type 2 diabetes in real clinical practice.
Results. There were high 10-year risks of arterial hypertension (OR 1.81; 95% CI 1.7751; 1.8594; p<0.0001), dyslipidemia (OR 1.2; 95% CI 1.165; 1.235; p<0.0001), diabetes type 2 (OR 1.2; 95% CI 1.165; 1.235; p<0.0001), myocardial infarctions and strokes (OR 2.26; 95% CI 2.167; 2.363; p<0.0001). The 10-year risk of cardiovascular events (myocardial infarction and stroke) exceeded
20% in males over 45 years old with arterial hypertension and type 2 diabetes concomitant with obesity grade I, as well as in patients of both sexes aged ≥50 years with a combination of diabetes type 2, arterial hypertension or dyslipidemia with obesity grade I. Drug therapy for obesity grade I is used in no more than 0.08% of cases In Russia. Metformin is the main component of drug
therapy for type 2 diabetes in 95% of patients with obesity grade I.

Conclusion. In real clinical practice in the Russian Federation, patients with obesity grade I rarely receive therapy or surgical treatment. At the same time, obesity grade I is associated with high 10-year risk of arterial hypertension, dyslipidemia, type 2 diabetes mellitus, myocardial infarctions and strokes.