DIFFERENT CONTRIBUTION OF OBESITY (BODY MASS INDEX VS. WAIST CIRCUMFERENCE) AS A PREDICTOR FOR DEVELOPMENT OF MAJOR CARDIOVASCULAR RISKS: DATA FROM KOREAN NATIONAL HEALTH INSURANCE SERVICE - NATIONAL SAMPLE COHORT (NHIS-NSC)

초록

Objective: Population based study demonstrated that obesity (defined as increased body mass index, BMI) is important predictor for developing hypertension and diabetes mellitus (DM), which have been well known major cardiovascular (CV) risk factors. Increased waist circumference (WC) representative of central obesity is focused as main factor for developing CV disease and its major risks. This study was to evaluate obesity as a predictor for new onset of hypertension and DM within 2-year in previously normotensives or normoglycemic subjects. Design and Method: The Korean National Health Insurance Service – National Sample Cohort (NHIS-NSC) established data about BMI and WC with medical, social and familial histories in 2009 and have been followed up for 2 years. Among total 349257 subjects with age more than 20 year-old, 95124 (normotensive group: 75.2% of population were 25–55 year-old, 54121(56.9%) male) of normotensives for evaluate new hypertension and 120501 (normoglycemic group: 83.6% of population were 25–65 year-old, 67183 (55.8%) male) normoglycemic subjects for evaluate new DM were analyzed. Results: During 2-year follow-up period, 3773 (3.97%) new hypertension in normotensive group and 1594 (1.32%) new DM in normoglycemic group were developed. Logistic regression analysis revealed that BMI was independent predictor (Exp(B) = 1.18, Sig < 0.001) for new onset hypertension with age (Exp(B) = 1.31, Sig < 0.001), sex (Exp(B) = 0.664, Sig < 0.001), dyslipidemia and family history of hypertension. For new onset DM, WC (Exp(B) = 1.04, Sig < 0.001), age (Exp(B) = 1.26, Sig < 0.001), sex (Exp(B) = 0.664, Sig < 0.001) and family history of DM (Exp(B) = 1.76, Sig < 0.001) were the independent predictors. Conclusions: Increase of BMI is independent predictor for new onset hypertension and increase of WC is independent predictor for new onset DM within 2-year. Obesity type might affects development of different major CV risks and hence, obesity itself is the important risk factor for CV disease.