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Comparative Study
. 2018 Aug 3;10(8):1011.
doi: 10.3390/nu10081011.

Different Risk for Hypertension, Diabetes, Dyslipidemia, and Hyperuricemia According to Level of Body Mass Index in Japanese and American Subjects

Masanari Kuwabara  1   2   3 , Remi Kuwabara  4 , Koichiro Niwa  5 , Ichiro Hisatome  6 , Gerard Smits  7 , Carlos A Roncal-Jimenez  8 , Paul S MacLean  9 , Joseph M Yracheta  10 , Minoru Ohno  11 , Miguel A Lanaspa  12 , Richard J Johnson  13 , Diana I Jalal  14
Affiliations
Comparative Study

Different Risk for Hypertension, Diabetes, Dyslipidemia, and Hyperuricemia According to Level of Body Mass Index in Japanese and American Subjects

Masanari Kuwabara et al. Nutrients. .

Abstract

Obesity is a risk factor for hypertension, diabetes mellitus (DM), dyslipidemia, and hyperuricemia. Here, we evaluated whether the same body mass index (BMI) for the U.S. population conferred similar metabolic risk in Japan. This was a cross-sectional analysis involving 90,047 Japanese adults (18⁻85 years) from St. Luke's International Hospital, Tokyo, Japan and 14,734 adults from National Health and Nutrition Examination Survey (NHANES) collected in the U.S. We compared the prevalence of hypertension, DM, dyslipidemia, and hyperuricemia according to BMI in Japan and the U.S. The prevalence of hypertension, DM, and dyslipidemia were significantly higher in the U.S. than Japan, whereas the prevalence of hyperuricemia did not differ between countries. Higher BMI was an independent risk factor for hypertension, DM, dyslipidemia, and hyperuricemia both in Japan and in the U.S. after adjusting for age, sex, smoking and drinking habits, chronic kidney disease, and other cardiovascular risk factors. The BMI cut-off above which the prevalence of these cardio-metabolic risk factors increased was significantly higher in the U.S. than in Japan (27 vs. 23 kg/m² for hypertension, 29 vs. 23 kg/m² for DM, 26 vs. 22 kg/m² for dyslipidemia, and 27 vs. 23 kg/m² for hyperuricemia). Higher BMI is associated with an increased prevalence of hypertension, DM, dyslipidemia, and hyperuricemia both in Japan and U.S. The BMI cut-off above which the prevalence of cardio-metabolic risk factors increases is significantly lower in Japan than the U.S., suggesting that the same definition of overweight/obesity may not be similarly applicable in both countries.

Keywords: body mass index; epidemiology; hypertension; risk factor.

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Conflict of interest statement

Johnson has equity with XORT Therapeutics, which is developing novel xanthine oxidase inhibitors, and with Colorado Research Partners LLC which is developing inhibitors of fructose metabolism. In addition, Johnson is an inventor on several patents licensed to XORT Therapeutics. (U.S. Patent No 7,799,794, U.S. Patent No. 8,557,831). The other authors have nothing to disclose.

Figures

Figure 1
Figure 1
Flow diagram of study design.
Figure 2
Figure 2
The prevalence of hypertension, diabetes mellitus, dyslipidemia, and hyperuricemia in each body mass index between Japan and the United States of America (U.S.). Solid blue lines showed mean prevalence of each disease in Japan and solid red lines showed the mean prevalence of each disease in the U.S. Dashed lines showed the proper cut-off points of body mass index for each disease, which shows higher than mean prevalence of each disease.
Figure 3
Figure 3
The prevalence of hypertension, diabetes mellitus, dyslipidemia, and hyperuricemia in each classification of body mass index (lean, normal, overweight, obesity, and severe obesity) between Japan and the United States of America (U.S.). p value < 0.05 shows significant difference of prevalence of each disease between Japan and the U.S. by χ2 analyses.
Figure 4
Figure 4
The prevalence of hypertension, diabetes mellitus, dyslipidemia, and hyperuricemia among White Americans, Black Americans, and Mexican Americans. Solid blue lines showed mean prevalence of each disease in White American, solid green lines showed mean prevalence of Black Americans, and solid red lines showed the mean prevalence in Mexican Americans. Dashed lines showed the proper cut-off points of body mass index for each disease, which shows higher than mean prevalence of each disease.
Figure 5
Figure 5
Odds ratio and 95% confidence interval of lean, overweight, obesity, and severe obesity for hypertension, diabetes mellitus, dyslipidemia, and hyperuricemia compared with the normal body mass index (18.5 ≤ BMI < 25 kg/m2).
See this image and copyright information in PMC

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