TWO YEAR IMPACT OF ABDOMINAL CIRCUMFERENCE ON THE NEW ONSET DIABETES MELLITUS AND HYPERTENSION INDEPENDENTLY OF BODY MASS INDEX IN KOREAN NATIONAL HEALTH INSURANCE SERVICE - NATIONAL SAMPLE COHORT (NHIS-NSC)

Abstract

Background: Metabolic disturbance is important risk factor for cardiovascular events. And identifying incident diabetes mellitus (DM) and hypertension (HTN) in short-term period as surrogate markers could be clinically useful in caring the candidate subjects for more active engagement in intervention against metabolic disturbance.

Design and method: Using Korean National Health Insurance Service – National Sample Cohort (NHIS-NSC) 2009 ∼2010, 113959 subjects aged 45 or more were analyzed. Abdominal obesity was defined as abdominal circumference (AC) 390 cm in male and 385 cm in female. Cut-off value for BMI was 25 kg/m2. Subjects were categorized as group I (high BMI and high AC), group II (high BMI and normal AC), group III (normal BMI and high AC), and group IV (normal BMI and normal AC). New onset DM or HTN was defined as fasting blood glucose 3126 mg/dL or blood pressure 3140/90 at annual health examination or newly prescribed antidiabetic or antihypertensive medication.

Results: Age was 57.7 ± 8.7 and female was 50.1% (n = 56829). At baseline, the prevalence of DM was 13.6% (n = 15546); 21.5%, 20.5%, 13.2%, and 10.7% for group I∼IV, respectively. HTN was 47.5% (n = 54207); 66.1%, 60.6%, 52.1%, and 39.4% for group I∼IV, respectively. Among 98413 DM naïve subjects, 2799 DM was newly diagnosed during 24 month follow up (772/17357 (4.4%), 146/4298 (3.4%), 488/15342 (3.2%), and 1393/61416 (2.3%)) for group I∼IV, respectively, p for log rank < 0.0001). For 59752 HTN naïve subjects, new onset HTN were diagnosed in 23.9%, 20.9%, 16.3%, and 14.9% for group I∼IV, respectively (p for log rank < 0.0001).

Conclusions: The group stratified by BMI and abdominal obesity was significant factor for incident DM and HTN. Compared to normal subjects, isolated abdominal obesity as the risk factor for new onset DM was comparable to increased BMI.