# Sex Differences in Cardiometabolic Risk in Adults With Type 2 Diabetes Mellitus Attending a Regional Referral Hospital in Kenya: A Cross-Sectional Study

## TL;DR

This study found that women with type 2 diabetes in Kenya have higher cardiometabolic risks than men, but these differences shrink when age is considered.

## Contribution

The study provides new insights into sex differences in cardiometabolic risk factors among adults with type 2 diabetes in Kenya.

## Key findings

- Females were more likely to have hypertension, obesity, and higher waist measurements than males.
- Age adjustment reduced the observed sex differences in cardiometabolic risks.
- Older adults (50-65 years) had lower odds of high BMI compared to younger adults.

## Abstract

Introduction: Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cardiometabolic complications, with attendant morbidity and mortality worldwide. Evidence suggests sex-linked disparities in cardiometabolic risks due to biological, social, behavioral, and socioeconomic determinants. However, sex-linked cardiometabolic risks among adults with T2DM in Kenya are poorly understood. This study examined sex differences in cardiometabolic risk factors among adults with T2DM attending Embu County Referral Hospital in Kenya.

Materials and methods: This cross-sectional study included 136 adults with T2DM aged ≥18 years who were diagnosed at least six months earlier. Data were collected using a researcher-administered questionnaire. Physiological and anthropometric measurements, including body mass index (BMI), waist-hip ratio (WHR), blood pressure (BP), random blood glucose (RBG), and glycated haemoglobin (HbA1c), were measured. Data analysis involved descriptive and inferential statistics, including age-adjusted logistic regression analyses of cardiometabolic risks by sex. The p-value was set at ≤0.05.

Results: Participants were predominantly female (69.9%), with a mean (±SD) age of 56.34 (±13.83) years. Females were more likely than males to have a prior hypertension diagnosis (73.33% vs. 26.67%; p < 0.001), be obese (88.9% vs. 11.1%; p = 0.003), have a higher waist circumference (93.6% vs. 6.4%; p < 0.001), and have a higher WHR (97.7% vs. 2.3%; p < 0.001). No significant sex differences were observed in RBG, HbA1c, or BP measurements. After age adjustment, sex was not independently associated with the cardiometabolic risks. Adults aged 50-65 years had significantly lower odds of high BMI compared with those aged <50 years (AOR = 0.35, 95% CI: 0.13-0.92; p = 0.033). Females showed a lower, but statistically nonsignificant, adjusted odds of poor glycemic control.

Conclusions: Notable sex differences in key sociodemographic characteristics and cardiometabolic markers were observed, though attenuated by age adjustment. These findings underscore the need for age- and sex-specific preventive and management strategies to improve cardiometabolic outcomes.