Cardiometabolic abnormalities among normal-weight persons from five racial/ethnic groups in the United States: A cross-sectional analysis of two cohort studies

Unjali P. Gujral*, Eric Vittinghoff, Morgana Mongraw-Chaffin, Dhananjay Vaidya, Namratha R. Kandula, Matthew Allison, Jeffrey Carr, Kiang Liu, K. M.Venkat Narayan, Alka M. Kanaya

*Corresponding author for this work

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Abstract

Background: The relationship between body weight and cardiometabolic disease may vary substantially by race/ethnicity. Objective: To determine the prevalence and correlates of the phenotype of metabolic abnormality but normal weight (MAN) for 5 racial/ethnic groups. Design: Cross-sectional analysis. Setting: 2 community-based cohorts. Participants: 2622 white, 803 Chinese American, 1893 African American, and 1496 Hispanic persons from MESA (Multi-Ethnic Study of Atherosclerosis) and 803 South Asian participants in the MASALA (Mediators of Atherosclerosis in South Asians Living in America) study. Measurements: Prevalence of 2 or more cardiometabolic abnormalities (high fasting glucose, low high-density lipoprotein cholesterol, and high triglyceride levels and hypertension) among normal-weight participants was estimated. Correlates of MAN were assessed by using log-binomial models. Results: Among normal-weight participants (n = 846 whites, 323 Chinese Americans, 334 African Americans, 252 Hispanics, and 195 South Asians), the prevalence of MAN was 21.0% (95% CI, 18.4% to 23.9%) in whites, 32.2% (CI, 27.3% to 37.4%) in Chinese Americans, 31.1% (CI, 26.3% to 36.3%) in African Americans, 38.5% (CI, 32.6% to 44.6%) in Hispanics, and 43.6% (CI, 36.8% to 50.6%) in South Asians. Adjustment for demographic, behavioral, and ectopic body fat measures did not explain racial/ethnic differences. After adjustment for age, sex, and race/ethnicity-body mass index (BMI) interaction, for the equivalent MAN prevalence at a BMI of 25.0 kg/m2 in whites, the corresponding BMI values were 22.9 kg/m2 (CI, 19.5 to 26.3 kg/m2) in African Americans, 21.5 kg/m2 (CI, 18.5 to 24.5 kg/m2) in Hispanics, 20.9 kg/m2 (CI, 19.7 to 22.1 kg/m2) in Chinese Americans, and 19.6 kg/m2 (CI, 17.2 to 22.0 kg/m2) in South Asians. Limitation: Cross-sectional study design and lack of harmonized dietary data between studies. Conclusion: Compared with whites, all racial/ethnic minority groups had a statistically significantly higher prevalence of MAN, which was not explained by demographic, behavioral, or ectopic fat measures. Using a BMI criterion for overweight to screen for cardiometabolic risk may result in a large proportion of racial/ethnic minority groups being overlooked. Primary Funding Source: National Institutes of Health.

Original languageEnglish (US)
Pages (from-to)628-636
Number of pages9
JournalAnnals of internal medicine
Volume166
Issue number9
DOIs
StatePublished - May 2 2017

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Ethnic Groups
Asian Americans
Cohort Studies
Hispanic Americans
Cross-Sectional Studies
African Americans
Weights and Measures
Body Mass Index
Minority Groups
Atherosclerosis
Demography
Body Weights and Measures
National Institutes of Health (U.S.)
Statistical Models
LDL Cholesterol
HDL Cholesterol
Adipose Tissue
Fasting
Triglycerides
Fats

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Gujral, Unjali P. ; Vittinghoff, Eric ; Mongraw-Chaffin, Morgana ; Vaidya, Dhananjay ; Kandula, Namratha R. ; Allison, Matthew ; Carr, Jeffrey ; Liu, Kiang ; Narayan, K. M.Venkat ; Kanaya, Alka M. / Cardiometabolic abnormalities among normal-weight persons from five racial/ethnic groups in the United States : A cross-sectional analysis of two cohort studies. In: Annals of internal medicine. 2017 ; Vol. 166, No. 9. pp. 628-636.
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abstract = "Background: The relationship between body weight and cardiometabolic disease may vary substantially by race/ethnicity. Objective: To determine the prevalence and correlates of the phenotype of metabolic abnormality but normal weight (MAN) for 5 racial/ethnic groups. Design: Cross-sectional analysis. Setting: 2 community-based cohorts. Participants: 2622 white, 803 Chinese American, 1893 African American, and 1496 Hispanic persons from MESA (Multi-Ethnic Study of Atherosclerosis) and 803 South Asian participants in the MASALA (Mediators of Atherosclerosis in South Asians Living in America) study. Measurements: Prevalence of 2 or more cardiometabolic abnormalities (high fasting glucose, low high-density lipoprotein cholesterol, and high triglyceride levels and hypertension) among normal-weight participants was estimated. Correlates of MAN were assessed by using log-binomial models. Results: Among normal-weight participants (n = 846 whites, 323 Chinese Americans, 334 African Americans, 252 Hispanics, and 195 South Asians), the prevalence of MAN was 21.0{\%} (95{\%} CI, 18.4{\%} to 23.9{\%}) in whites, 32.2{\%} (CI, 27.3{\%} to 37.4{\%}) in Chinese Americans, 31.1{\%} (CI, 26.3{\%} to 36.3{\%}) in African Americans, 38.5{\%} (CI, 32.6{\%} to 44.6{\%}) in Hispanics, and 43.6{\%} (CI, 36.8{\%} to 50.6{\%}) in South Asians. Adjustment for demographic, behavioral, and ectopic body fat measures did not explain racial/ethnic differences. After adjustment for age, sex, and race/ethnicity-body mass index (BMI) interaction, for the equivalent MAN prevalence at a BMI of 25.0 kg/m2 in whites, the corresponding BMI values were 22.9 kg/m2 (CI, 19.5 to 26.3 kg/m2) in African Americans, 21.5 kg/m2 (CI, 18.5 to 24.5 kg/m2) in Hispanics, 20.9 kg/m2 (CI, 19.7 to 22.1 kg/m2) in Chinese Americans, and 19.6 kg/m2 (CI, 17.2 to 22.0 kg/m2) in South Asians. Limitation: Cross-sectional study design and lack of harmonized dietary data between studies. Conclusion: Compared with whites, all racial/ethnic minority groups had a statistically significantly higher prevalence of MAN, which was not explained by demographic, behavioral, or ectopic fat measures. Using a BMI criterion for overweight to screen for cardiometabolic risk may result in a large proportion of racial/ethnic minority groups being overlooked. Primary Funding Source: National Institutes of Health.",
author = "Gujral, {Unjali P.} and Eric Vittinghoff and Morgana Mongraw-Chaffin and Dhananjay Vaidya and Kandula, {Namratha R.} and Matthew Allison and Jeffrey Carr and Kiang Liu and Narayan, {K. M.Venkat} and Kanaya, {Alka M.}",
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Cardiometabolic abnormalities among normal-weight persons from five racial/ethnic groups in the United States : A cross-sectional analysis of two cohort studies. / Gujral, Unjali P.; Vittinghoff, Eric; Mongraw-Chaffin, Morgana; Vaidya, Dhananjay; Kandula, Namratha R.; Allison, Matthew; Carr, Jeffrey; Liu, Kiang; Narayan, K. M.Venkat; Kanaya, Alka M.

In: Annals of internal medicine, Vol. 166, No. 9, 02.05.2017, p. 628-636.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cardiometabolic abnormalities among normal-weight persons from five racial/ethnic groups in the United States

T2 - A cross-sectional analysis of two cohort studies

AU - Gujral, Unjali P.

AU - Vittinghoff, Eric

AU - Mongraw-Chaffin, Morgana

AU - Vaidya, Dhananjay

AU - Kandula, Namratha R.

AU - Allison, Matthew

AU - Carr, Jeffrey

AU - Liu, Kiang

AU - Narayan, K. M.Venkat

AU - Kanaya, Alka M.

PY - 2017/5/2

Y1 - 2017/5/2

N2 - Background: The relationship between body weight and cardiometabolic disease may vary substantially by race/ethnicity. Objective: To determine the prevalence and correlates of the phenotype of metabolic abnormality but normal weight (MAN) for 5 racial/ethnic groups. Design: Cross-sectional analysis. Setting: 2 community-based cohorts. Participants: 2622 white, 803 Chinese American, 1893 African American, and 1496 Hispanic persons from MESA (Multi-Ethnic Study of Atherosclerosis) and 803 South Asian participants in the MASALA (Mediators of Atherosclerosis in South Asians Living in America) study. Measurements: Prevalence of 2 or more cardiometabolic abnormalities (high fasting glucose, low high-density lipoprotein cholesterol, and high triglyceride levels and hypertension) among normal-weight participants was estimated. Correlates of MAN were assessed by using log-binomial models. Results: Among normal-weight participants (n = 846 whites, 323 Chinese Americans, 334 African Americans, 252 Hispanics, and 195 South Asians), the prevalence of MAN was 21.0% (95% CI, 18.4% to 23.9%) in whites, 32.2% (CI, 27.3% to 37.4%) in Chinese Americans, 31.1% (CI, 26.3% to 36.3%) in African Americans, 38.5% (CI, 32.6% to 44.6%) in Hispanics, and 43.6% (CI, 36.8% to 50.6%) in South Asians. Adjustment for demographic, behavioral, and ectopic body fat measures did not explain racial/ethnic differences. After adjustment for age, sex, and race/ethnicity-body mass index (BMI) interaction, for the equivalent MAN prevalence at a BMI of 25.0 kg/m2 in whites, the corresponding BMI values were 22.9 kg/m2 (CI, 19.5 to 26.3 kg/m2) in African Americans, 21.5 kg/m2 (CI, 18.5 to 24.5 kg/m2) in Hispanics, 20.9 kg/m2 (CI, 19.7 to 22.1 kg/m2) in Chinese Americans, and 19.6 kg/m2 (CI, 17.2 to 22.0 kg/m2) in South Asians. Limitation: Cross-sectional study design and lack of harmonized dietary data between studies. Conclusion: Compared with whites, all racial/ethnic minority groups had a statistically significantly higher prevalence of MAN, which was not explained by demographic, behavioral, or ectopic fat measures. Using a BMI criterion for overweight to screen for cardiometabolic risk may result in a large proportion of racial/ethnic minority groups being overlooked. Primary Funding Source: National Institutes of Health.

AB - Background: The relationship between body weight and cardiometabolic disease may vary substantially by race/ethnicity. Objective: To determine the prevalence and correlates of the phenotype of metabolic abnormality but normal weight (MAN) for 5 racial/ethnic groups. Design: Cross-sectional analysis. Setting: 2 community-based cohorts. Participants: 2622 white, 803 Chinese American, 1893 African American, and 1496 Hispanic persons from MESA (Multi-Ethnic Study of Atherosclerosis) and 803 South Asian participants in the MASALA (Mediators of Atherosclerosis in South Asians Living in America) study. Measurements: Prevalence of 2 or more cardiometabolic abnormalities (high fasting glucose, low high-density lipoprotein cholesterol, and high triglyceride levels and hypertension) among normal-weight participants was estimated. Correlates of MAN were assessed by using log-binomial models. Results: Among normal-weight participants (n = 846 whites, 323 Chinese Americans, 334 African Americans, 252 Hispanics, and 195 South Asians), the prevalence of MAN was 21.0% (95% CI, 18.4% to 23.9%) in whites, 32.2% (CI, 27.3% to 37.4%) in Chinese Americans, 31.1% (CI, 26.3% to 36.3%) in African Americans, 38.5% (CI, 32.6% to 44.6%) in Hispanics, and 43.6% (CI, 36.8% to 50.6%) in South Asians. Adjustment for demographic, behavioral, and ectopic body fat measures did not explain racial/ethnic differences. After adjustment for age, sex, and race/ethnicity-body mass index (BMI) interaction, for the equivalent MAN prevalence at a BMI of 25.0 kg/m2 in whites, the corresponding BMI values were 22.9 kg/m2 (CI, 19.5 to 26.3 kg/m2) in African Americans, 21.5 kg/m2 (CI, 18.5 to 24.5 kg/m2) in Hispanics, 20.9 kg/m2 (CI, 19.7 to 22.1 kg/m2) in Chinese Americans, and 19.6 kg/m2 (CI, 17.2 to 22.0 kg/m2) in South Asians. Limitation: Cross-sectional study design and lack of harmonized dietary data between studies. Conclusion: Compared with whites, all racial/ethnic minority groups had a statistically significantly higher prevalence of MAN, which was not explained by demographic, behavioral, or ectopic fat measures. Using a BMI criterion for overweight to screen for cardiometabolic risk may result in a large proportion of racial/ethnic minority groups being overlooked. Primary Funding Source: National Institutes of Health.

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