Abstract
BackgroundSeveral studies have shown that normal weight central obesity (NWCO) is associated with cardiovascular disease (CVD) risk factors. However, studies conducted in the Japanese population have been very limited. Thus, the relationships between normal weight central obesity, classified using body mass index (BMI), the waist-to-height ratio (WHtR), and CVD risk factors in middle-aged Japanese adults were investigated.MethodsThe participants were Japanese adults aged 40–64 years who had undergone periodic health examinations in Japan during the period from April 2013 to March 2014. The participants were categorized into the following four groups: normal weight (BMI 18.5–24.9 kg/m2) and no central obesity (WHtR < 0.5) (NW); normal weight and central obesity (WHtR ≥ 0.5) (NWCO); obesity (BMI ≥ 25 kg/m2) and no central obesity (OB); and obesity and central obesity (OBCO). Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or taking medication for hypertension. Dyslipidemia was defined as LDL-C ≥ 140 mg/dl, HDL-C < 40 mg/dl, triglyceride ≥ 150 mg/dl, or taking medication for dyslipidemia. Diabetes was defined as fasting plasma glucose ≥ 126 mg/dl, random plasma glucose ≥ 200 mg/dl, HbA1c ≥ 6.5%, or receiving medical treatment for diabetes mellitus. A logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for hypertension, dyslipidemia, and diabetes.ResultsA total of 117,163 participants (82,487 men and 34,676 women) were analyzed. The prevalence of NWCO was 15.6% in men and 30.2% in women. With reference to NW, the ORs for hypertension (adjusted OR 1.22, 95% CI 1.17–1.27 in men, 1.23, 1.16–1.31 in women), dyslipidemia (1.81, 1.74–1.89 in men, 1.60, 1.52–1.69 in women), and diabetes (1.35, 1.25–1.46 in men, 1.60, 1.35–1.90 in women) were significantly higher in NWCO.ConclusionsNormal weight with central obesity was associated with CVD risk factors, such as hypertension, dyslipidemia, and diabetes, compared with normal weight without central obesity, regardless of sex. It is important to focus on normal weight with central obesity for the prevention of CVD in Japanese middle-aged adults.
Highlights
Several studies have shown that normal weight central obesity (NWCO) is associated with cardiovascular disease (CVD) risk factors
Data are expressed as medians (25th percentile, 75th percentile) or n (%) BMI, body mass index; WC, waist circumference; WHtR, waist-to-height ratio; Normal weight and no central obesity (NW), normal weight no central obesity; NWCO, normal weight central obesity; OB, obesity no central obesity; obesity and central obesity (OBCO), obesity central obesity compared with NW, the adjusted odds ratios (ORs) for hypertension, dyslipidemia (1.84, 1.76–1.93 in men; 1.85, 1.70–2.01 in women), and diabetes (1.83, 1.70–1.97 in men; 3.11, 2.57–3.77 in women) were significantly increased in OBCO, regardless of sex
Adjusted for age, weight, smoking status, alcohol intake, and physical activity NW, normal weight no central obesity; NWCO, normal weight central obesity; OB, obesity no central obesity; OBCO, obesity central obesity; OR, odds ratio; 95% CI, 95% confidence interval
Summary
Several studies have shown that normal weight central obesity (NWCO) is associated with cardiovascular disease (CVD) risk factors. The relationships between normal weight central obesity, classified using body mass index (BMI), the waist-to-height ratio (WHtR), and CVD risk factors in middle-aged Japanese adults were investigated. A recent study showed that abdominal obesity is associated with insulin resistance and higher risks of metabolic syndrome and CVD, whereas general obesity is not [2]. “normal weight central obesity,” defined by considering general obesity and central obesity, has been shown to be associated with CVD risk factors and increased mortality [3]. A previous systematic review demonstrated that, as indices of abdominal obesity, the WHtR was a better predictor than BMI and WC for diabetes, dyslipidemia, hypertension, and CVD in both sexes in populations of various nationalities [6]. It is effective to use BMI and the WHtR for defining general obesity and central obesity
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