Abstract
(1) Background: Despite having consistently lower rates of obesity than other ethnic groups, Asian Americans (AAs) are more likely to be identified as metabolically obese, suggesting an ethnic-specific association between BMI and cardiometabolic outcomes. The goal of this study was to provide an estimate of metabolic syndrome (MetS) prevalence among AAs using national survey data and to compare this rate to that of non-Hispanic Whites (NHWs) over the BMI continuum. (2) Methods: Using the NHANES 2011–2016 data, we computed age-adjusted, gender-specific prevalence of MetS and its individual components for three BMI categories. Furthermore, we conducted multivariate binary logistic regression to examine the risk of MetS in AAs compared to NHWs, controlling for sociodemographic and lifestyle factors. The analysis sample consisted of 2121 AAs and 6318 NHWs. (3) Results: Among AAs, the prevalence of MetS and its components increased with higher BMI levels, with overall prevalence being 5.23% for BMI < 23, 38.23% for BMI of 23–27.4, and 77.68% for BMI ≥ 27.5 in men; and 18.61% for BMI < 23, 47.82% for BMI of 23–27.4, and 67.73% for BMI ≥ 27.5 in women. We also found that for those with a BMI > 23, AAs had a higher predicted risk of MetS than their NHW counterparts of the same BMI level, in both men and women. (4) Conclusions: Our findings support the use of lower BMI ranges for defining overweight and obesity in Asian populations, which would allow for earlier and more appropriate screening for MetS and may better facilitate prevention efforts.
Highlights
Metabolic syndrome (MetS) is a collection of metabolic conditions associated with an increased risk of type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), and all-cause mortality [1,2,3,4,5,6]
The analysis sample consisted of 2121 AAs and 6318 non-Hispanic Whites (NHWs). (3) Results: Among AAs, the prevalence of MetS and its components increased with higher body mass index (BMI) levels, with overall prevalence being 5.23% for BMI < 23, 38.23% for BMI of 23–27.4, and 77.68% for BMI ≥ 27.5 in men; and 18.61% for BMI < 23, 47.82% for BMI of 23–27.4, and 67.73% for BMI ≥ 27.5 in women
We developed four categories based on the cut-off points from the 2018 Physical Activity Guidelines for Americans [46]: sedentary, insufficient, moderate, and high [47]
Summary
Metabolic syndrome (MetS) is a collection of metabolic conditions associated with an increased risk of type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), and all-cause mortality [1,2,3,4,5,6]. Researchers have found that despite having consistently lower body mass index (BMI) than other ethnic groups [20,21,22], Asian Americans in aggregate and certain subgroups are at higher risk for hypertension [23,24,25], elevated blood glucose [26,27,28], and CVD [29,30,31]. Compared to individuals with similar BMI levels, subjects identified as MONW are often characterized by having altered insulin sensitivity and lipid profile, greater abdominal adiposity, and higher blood pressure [34]. The “lean yet unhealthy” phenomenon in Asian Americans is thought to be the result of greater percentage of body fat accumulation at a given BMI level [32], suggesting an ethnic-specific association between body fat percentage and BMI [13]
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