Asian linear BMI heart disease risk

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Hi All,

It seems that there is in an Asian population a linear BMI-heart disease risk

association.

The pdf-available below is not yet in Medline.

Sun Ha Jee, o Pastor-Barriuso, Lawrence J. Appel, Il Suh, Edgar R. ,

III, and Eliseo Guallar

Body Mass Index and Incident Ischemic Heart Disease in South Korean Men and

Women

Am. J. Epidemiol. 2005 162: 42-48

Asian populations have a higher body fat percentage for a given body mass index

(BMI) than Caucasians. However, little information is available on the

association

of BMI with ischemic heart disease (IHD) incidence in Asians at low BMI levels.

The

authors prospectively evaluated the association of BMI (weight (kg)/height (m)2)

with IHD incidence over 9 years of follow-up (1993–2001) among 133,740 South

Korean

adults (89,050 men, 44,690 women) who participated in the 1990 and 1992

examinations

of the Korea Medical Insurance Corporation Study. Average BMI at baseline was

23.4

(standard deviation, 2.3) in men and 22.3 (standard deviation, 2.3) in women.

After

multivariate adjustment, there was a 14% (95% confidence interval: 12, 16)

increased

risk of incident IHD per unit of increase in BMI. This trend was also observed

within the range considered normal by Western standards, and a BMI of 24–<25 was

associated with an IHD hazard ratio of 2.01 (95% confidence interval: 1.32,

3.05) in

comparison with a BMI of 18–<19. The association of BMI with IHD in this cohort

of

relatively young South Korean men and women was progressive over the range of

BMI

values, with no threshold of change in risk and no indication of a U-shaped

relation

at low BMI levels.

.... TABLE 2. Hazard ratios for incident ischemic heart disease and acute

myocardial

infarction by body mass index category, Korea Medical Insurance Corporation

Study,

South Korea, 1993–2001

----------------------------------------------

---------------Ischemic heart disease Acute myocardial infarction

------------------------------------------------

Body mass index No. % No. of events---Model 1† Model 2‡---No. of events---Model

1†

Model 2‡

------------------HR 95% CI HR 95% CI--------HR 95% CI HR 95% CI

----------------------------------------------

18–<19 4,100 3.1 24 1.00* 1.00* 8 1.00* 1.00*

19–<20 9,159 6.8 68 1.17 0.74, 1.87 1.13 0.71, 1.80 22 1.07 0.48, 2.41 1.01

0.45,

2.26

20–<21 15,127 11.3 123 1.20 0.77, 1.85 1.11 0.72, 1.72 42 1.12 0.53, 2.40 0.99

0.47,

2.12

21–<22 19,104 14.3 193 1.40 0.91, 2.24 1.26 0.82, 1.92 72 1.41 0.68, 2.92 1.19

0.57,

2.48

22–<23 21,114 15.8 238 1.47 0.97, 2.24 1.25 0.82, 1.90 74 1.23 0.59, 2.54 0.95

0.46,

1.98

23–<24 20,564 15.4 327 1.97 1.30, 2.99 1.62 1.07, 2.45 113 1.80 0.88, 3.70 1.34

0.65, 2.76

24–<25 17,633 13.2 298 2.01 1.32, 3.05 1.58 1.04, 2.40 111 1.96 0.95, 4.02 1.39

0.67, 2.85

25–<26 11,932 8.9 242 2.39 1.57, 3.64 1.82 1.20, 2.78 82 2.09 1.01, 4.32 1.43

0.69,

2.97

26–<27 7,349 5.5 163 2.61 1.70, 4.02 1.91 1.24, 2.95 57 2.37 1.13, 4.97 1.53

0.73,

3.22

27–<28 4,063 3.0 115 3.26 2.10, 5.07 2.30 1.47, 3.58 41 3.00 1.41, 6.42 1.84

0.86,

3.96

28–<29 1,982 1.5 56 3.29 2.04, 5.32 2.26 1.40, 3.66 24 3.68 1.65, 8.20 2.22

0.99,

4.96

29–<30 960 0.7 28 3.54 2.05, 6.11 2.36 1.36, 4.86 10 3.31 1.30, 8.39 1.91 0.75,

4.87

30 653 0.5 24 4.37 2.48, 7.69 2.75 1.55, 4.86 10 4.87 1.92, 12.34 2.60 1.02,

6.62

p for linear trend <0.001 <0.001 <0.001 <0.001

--------------------------------------------------------

† Hazard ratios were adjusted for age, sex, smoking (never smoker, past smoker,

or

current smoker of 1–9, 10–19, or 20 cigarettes/day), frequency of alcohol

drinking

(never, occasionally, or often), physical activity, and insurance premium (four

categories).

‡ Hazard ratios were further adjusted for hypertension (systolic blood pressure

140

mmHg or diastolic blood pressure 90 mmHg), diabetes (fasting glucose 126 mg/dl

or

previous diagnosis of diabetes), and total cholesterol levels.

HR, hazard ratio; CI, confidence interval.

* Reference category.

Al Pater, PhD; email: old542000@...

__________________________________

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