Diabetes, Metabolic Syndrome and Obesity (Sep 2025)
Prevalence and Comorbidity Network Analysis of Obesity and Related Complications: A Real-World Study Based on 233,004 Individuals
Abstract
Yaxin Xu,1,2,* Wenchang Jia,1,3,* Xiaoxuan Niu,4,* Jing Wen,1,2 Dingrong Ji,1,2 Xiaopan Li,1,5 Ming Liu,1,5 Sunfang Jiang1,2 1Department of Health Management Centre, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic of China; 2Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic of China; 3School of Public Health, Fudan University, Shanghai, 200032, People’s Republic of China; 4Department of Nutrition, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic of China; 5Shanghai Engineering Research Centre of AI Technology for Cardiopulmonary Diseases, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic of China*These authors contributed equally to this workCorrespondence: Sunfang Jiang, Department of Health Management Centre, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, People’s Republic of China, Tel +86 138 1759 7264, Email [email protected] Ming Liu, Department of Health Management Centre, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, People’s Republic of China, Tel +86 136 3658 4852, Email [email protected]: To determine the prevalence of overweight/obesity and their major complications, and to map comorbidity relationships by means of large-scale, real-world data.Patients and Methods: This cross-sectional study included individuals undergoing routine health examinations from January 2021 to April 2024. Clinical and demographic data were systematically collected. Obesity-related complications were diagnosed using standardized criteria. Descriptive statistics assessed prevalence; correlation and network analyses characterized comorbidity relationships.Results: A total of 233,004 participants (57.5% male; mean age 43.51 ± 13.28 years) were enrolled. Among these, 41.1% were overweight and 6.1% had obesity. The most prevalent complications were dyslipidemia (30.9%), fatty liver disease (26.4%), and hyperuricemia (20.0%). Over 60% of participants had at least one obesity-related comorbidity. Network analysis indicated a central disease cluster comprising overweight/obesity, fatty liver disease, hypertension, diabetes, and carotid plaque, with diabetes playing a key role linking metabolic abnormalities to cardiovascular risks.Conclusion: Overweight prevalence was high in this large-scale examined population and frequently coexisted with multiple metabolic and cardiovascular conditions. Network analysis highlighted diabetes as a central condition, supporting early targeted interventions for overweight individuals to reduce obesity-related chronic disease burden.Keywords: obesity, overweight, obesity-related complications, comorbidity network, epidemiology
