Asian Americans Have Greater Prevalence of Metabolic Syndrome Despite Lower Body Mass Index

Abstract

Objective

To examine the relationship between body mass index and metabolic syndrome for Asian Americans and non-Hispanic Whites, given that evidence shows racial/ethnic heterogeneity exists in how body mass index predicts metabolic syndrome.

Research Design and Methods

Electronic health records of 43 507 primary care patients aged 35 years and older with self-identified race/ethnicity of interest (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, or non-Hispanic White) were analyzed in a mixed-payer, outpatient-focused healthcare organization in the San Francisco Bay Area.

Results

Metabolic syndrome prevalence is significantly higher in Asians compared to non-Hispanic Whites for every body mass index category. For women at the mean age of 55 and body mass index of 25 kg/m ², the predicted prevalence of metabolic syndrome is 12% for non-Hispanic White women compared to 30% for Asians; similarly for men, the predicted prevalence of metabolic syndrome is 22% for non-Hispanic Whites compared to 43% of Asians. Compared to non-Hispanic White women and men with a body mass index of 25 kg/m ², comparable prevalence of metabolic syndrome was seen at body mass index of 19.6 kg/m ² for Asian women and 19.9 kg/m ² for Asian men. A similar pattern was seen in disaggregated Asian subgroups.

Conclusions

Despite lower body mass index values and lower prevalence of overweight/obesity than non-Hispanic Whites, Asian Americans have higher rates of metabolic syndrome over the range of body mass index. Our results indicate that body mass index ranges for defining overweight/obesity in Asian populations should be lower than for non-Hispanic Whites.