Prevalence of Cardiometabolic Abnormalities Among Male Licensed Pilots and Community Health Examination Participants in China: A Cross-Sectional Comparison.

Background: Metabolic abnormalities are common in adult populations, but comparative data between licensed pilots and community health examination participants in China remain limited. This study descriptively compared cardiometabolic abnormality profiles between male licensed pilots and male community health examination participants. Methods: This retrospective cross-sectional study used routine health examination data collected between July 2025 and September 2025, including 495 male licensed pilots undergoing aviation health examinations and 750 male adults undergoing community health examinations at the same hospital. The analysis was restricted to men because the aviation cohort was overwhelmingly male and female pilot data were too sparse for meaningful comparison. Crude and age-adjusted logistic regression models were used to compare cohorts, with age as the only adjustment variable. FDR correction, cohort-by-age interaction testing, and exact-age matched sensitivity analysis were performed. Results: Compared with the community cohort, the aviation cohort had lower prevalence of TG abnormality (8.3% vs. 18.1%), low HDL-C abnormality (12.1% vs. 18.5%), TC abnormality (7.5% vs. 15.5%), FPG abnormality (5.7% vs. 9.6%), and BP abnormality (2.2% vs. 33.1%). After age adjustment and FDR correction, aviation cohort membership remained associated with lower odds of TG abnormality (adjusted OR = 0.42, 95% CI: 0.29-0.61), low HDL-C abnormality (adjusted OR = 0.62, 95% CI: 0.45-0.87), TC abnormality (adjusted OR = 0.52, 95% CI: 0.35-0.77), and BP abnormality (adjusted OR = 0.05, 95% CI: 0.03-0.10). LDL-C, FPG, and BMI abnormalities were not significantly associated with cohort type after age adjustment. The overall burden of metabolic abnormalities was lower in the aviation cohort. Conclusion: Male licensed pilots showed lower prevalence and lower overall burden of selected cardiometabolic abnormalities compared with male community health examination participants. The marked BP difference should be interpreted cautiously in the context of aeromedical certification, fitness-for-duty requirements, healthy-worker selection, and potential BP recording differences. These findings should be interpreted as descriptive population-level differences rather than causal effects.