Discordant Risk: Overweight and Cardiometabolic Risk in Chinese Adults
2061.ris
—
Octet Stream,
2 kB (2666 bytes)
OBJECTIVE: Recent US work identified "metabolically healthy overweight" and "metabolically at risk normal weight" individuals. Less is known for modernizing countries with recent increased obesity. DESIGN AND METHODS: Fasting blood samples, anthropometry and blood pressure from 8,233 adults aged 18-98 in the 2009 nationwide China Health and Nutrition Survey, were used to determine prevalence of overweight (Asian cut point, BMI >/= 23 kg/m(2) ) and five risk factors (prediabetes/diabetes (hemoglobin A1c >/= 5.7%) inflammation (high-sensitivity C-reactive protein (hsCRP) >/= 3 mg/l), prehypertension/hypertension (Systolic blood pressure/diastolic blood pressure >/= 130/85 mm Hg), high triglycerides (>/= 150 mg/dl), low high-density lipoprotein cholesterol (<40 (men)/ <50 mg/dl (women)). Sex-stratified, logistic, and multinomial logistic regression models estimated concurrent obesity and cardiometabolic risk, with and without abdominal obesity, adjusting for age, smoking, alcohol consumption, physical activity, urbanicity, and income. RESULTS: Irrespective of urbanicity, 78.3% of the sample had >/= 1 elevated cardiometabolic risk factor (normal weight: 33.2% had >/= 1 elevated risk factor; overweight: 5.7% had none). At the age of 18-30 years, 47.4% had no elevated risk factors, which dropped to 6% by the age 70, largely due to age-related increase in hypertension risk (18-30 years: 11%; >70 years: 73%). Abdominal obesity was highly predictive of metabolic risk, irrespective of overweight (e.g., "metabolically at risk overweight" relative to "metabolically healthy normal weight" (men: relative risk ratio (RRR) = 39.06; 95% confidence interval (CI): 23.47, 65.00; women: RRR = 22.26; 95% CI: 17.49, 28.33)). CONCLUSION: A large proportion of Chinese adults have metabolic abnormalities. High hypertension risk with age, underlies the low prevalence of metabolically healthy overweight. Screening for cardiometabolic-related outcomes dependent upon overweight will likely miss a large portion of the Chinese at risk population.
JOUR
Gordon-Larsen, Penny
Adair, Linda S.
Meigs, James B.
Mayer-Davis, Elizabeth J.
Herring, Amy H.
Yan, Sheng-kai
Zhang, Bing
Du, Shufa
Popkin, Barry M.
2013
Obesity
21
1
E166-74
2013/03/19
1930-739X (Electronic) 1930-7381 (Linking)
10.1002/oby.20409
PMC3486953
NIHMS384725
2061