Hypertension and type 2 diabetes comorbidity in adults in the United States: risk of overall and regional adiposity.
OBJECTIVE
To evaluate the impact of generalized, abdominal, and truncal fat deposits on the risk of hypertension and/or diabetes and to determine whether ethnic differences in these fat patterns are independently associated with increased risk for the hypertension-diabetes comorbidity (HDC).


METHODS
Data (n = 7075) from the Third U.S. National Health and Nutrition Examination Survey were used for this investigation. To assess risks of hypertension and/or diabetes that were due to different fat patterns, odds ratios of men and women with various cut-points of adiposities were compared with normal subjects in logistic regression models, adjusting for age, smoking, and alcohol intake. To evaluate the contribution of ethnic differences in obesity to the risks of HDC, we compared blacks and Hispanics with whites.


RESULTS
Generalized and abdominal obesities were independently associated with increased risk of hypertension, diabetes and HDC in white, black, and Hispanic men and women. The risk of HDC due to generalized, truncal, and abdominal obesities tended to be higher in whites than blacks and Hispanics. In men, the contribution of black and Hispanic ethnicities to the increased risk of HDC due to the various obesity phenotypes was approximately 73% and approximately 61%, respectively. The corresponding values for black and Hispanic women were approximately 115% and approximately 125%, respectively.


CONCLUSIONS
In addition to advocating behavioral lifestyles to curb the epidemic of obesity among at-risk populations in the United States, there is also the need for primary health care practitioners to craft their advice to the degree and type of obesity in these at-risk groups.
Okosun
I S
IS
Department of Community Medicine, Mercer University School of Medicine, Macon, Georgia 31207, USA. okosun_i@mercer.edu
Chandra
K M
KM
Choi
S
S
Christman
J
J
Dever
G E
GE
Prewitt
T E
TE
D000273:Adipose Tissue / Q000033:anatomy & histology*; D000328:Adult; D001741:Black or African American; D000368:Aged; D015992:Body Mass Index; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000208:ethnology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology; D016017:Odds Ratio; D010641:Phenotype; D012044:Regression Analysis; D012307:Risk Factors; D012885:Skinfold Thickness; D014481:United States / Q000453:epidemiology; D044465:White People