From obesity to metabolic syndrome: disparities by disability type

Background

Inadequate obesity management creates a continuous metabolic pathway from dyslipidemia to metabolic syndrome, increasing cardiovascular and cerebrovascular risk. Although people with disabilities have a higher prevalence of obesity, evidence on progression to metabolic syndrome is limited. This study examined disparities in dyslipidemia and metabolic syndrome by disability status.

Methods

We analyzed adults aged ≥20 years with body mass index(BMI) data by linking National Health Insurance Service health check-up data with National disability registry(2009–2022). Disabilities were classified by presence, severity, and types. Dyslipidemia was defined by diagnosis or medication use, and metabolic syndrome as meeting ≥3 of 5 criteria. Trends were assessed, and odds ratios(ORs) were estimated using multivariable logistic regression controlling for age, income, residence, obesity, and smoking.

Results

The study included 16,254,619 non-disabled individuals(95.4%) and 785,162 individuals with disabilities(4.6%), who were older(62.5 vs. 49.3) and more likely to live in rural areas(13.5% vs. 7.9%). Obesity was more prevalent among individuals with disabilities(36.9% vs. 32.1%). From 2009 to 2022, prevalence of dyslipidemia and metabolic syndrome increased in both groups, remaining higher among individuals with disabilities. In 2022, multivariable analysis showed higher risks of both conditions among individuals with disabilities. Among men, the highest risks were observed in those with respiratory disabilities OR 1.92; OR 1.86), while among women, elevated risks were observed in those with mental and respiratory disabilities(OR 1.19; OR 1.59).

Conclusions

Dyslipidemia and metabolic syndrome form a continuous metabolic risk pathway and are more prevalent among people with disabilities. These findings highlight the importance of early detection and management, and improved healthcare access and tailored strategies addressing disability-related vulnerabilities.

Key messages

• Individuals with disabilities had consistently higher prevalence of dyslipidemia and metabolic syndrome than those without disabilities, with particularly elevated risks in specific disability types.

• The metabolic risk pathway linked to inadequate obesity management appears more vulnerable in individuals with disabilities, highlighting the need for early detection and improved healthcare access.