Higher Rates of Metabolic Abnormality but Normal Weight in Minority Patients

The percentage of Americans with normal body weight but cardiometabolic abnormalities is higher in racial/ethnic minority groups—especially South Asians and Hispanics, reports a study in Annals of Internal Medicine.

The researchers determined the prevalence of the metabolic abnormality but normal weight (MAN) phenotype and associated factors in five US racial/ethnic groups. Data on 2622 white, 803 Chinese American, 1893 African American, and 1496 Hispanic adults were drawn from the Multi-Ethnic Study of Atherosclerosis; information on 803 South Asian subjects came from the Mediators of Atherosclerosis in South Asians Living in America study. The MAN phenotype was defined as at least two of four cardiometabolic abnormalities: high fasting glucose, low high-density lipoprotein cholesterol, high triglycerides, and hypertension.

The prevalence of MAN was 21.0% in whites compared to 32.2% in Chinese Americans, 31.1% in African Americans, 38.5% in Hispanics, and 43.6% in South Asians. The differences remained significant on adjustment for demographic and behavioral factors and ectopic body fat.

The researchers performed further adjustment for a significant interaction between age, sex, and race/ethnicity with body mass index (BMI). Values equivalent to the MAN prevalence observed in whites with a BMI of 25.0 were 22.9 in African Americans, 21.5 in Hispanics, 20.9 in Chinese Americans, and 19.6 in South Asians.

The results suggest that US patients in racial/ethnic minority groups have a higher rate of cardiometabolic abnormalities at normal body weight, compared to their white counterparts. The researchers conclude: “Using a BMI criterion for overweight to screen for cardiometabolic risk may result in a large proportion of racial/ethnic minority groups being overlooked” [Gurjal UP, et al. Cardiometabolic abnormalities among normal-weight persons from five racial/ethnic groups in the United States: a cross-sectional analysis of two cohort studies. Ann Intern Med 2017; DOI: 10.7326/M16-1895].