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Generalised and abdominal obesity and risk of diabetes, hypertension and hypertension–diabetes co-morbidity in England

  • Vasant Hirani (a1), Paola Zaninotto (a1) and Paola Primatesta (a1)
Abstract
AbstractObjectives

To look at trends in generalised (body mass index (BMI) ≥30 kg m–2) and abdominal (waist circumference (WC) >102 cm in men, >88 cm in women) obesity among adults between 1993 and 2003, and to evaluate their association with diabetes, hypertension and hypertension–diabetes co-morbidity (HDC) in England.

Design

Analyses of nationally representative cross-sectional population surveys, the Health Survey for England (HSE).

Subjects

Non-institutionalised men and women aged ≥35 years.

Measurements

Interviewer-administered questionnaire (sociodemographic information, risk factors, doctor-diagnosed diabetes), measurements of height and weight to calculate BMI. WC and blood pressure measurements were taken by trained nurses.

Results

Generalised obesity increased among men from 15.8% in 1993 to 26.3% in 2003, and among women from 19.3% to 25.8%. Abdominal obesity also increased in both sexes (men: 26.2% in 1993 to 39.0% in 2003; women: 32.4% to 47.0%). In 1994, 1998 and 2003, generalised and abdominal obesity were independently associated with risk of hypertension, diabetes and HDC. The odds of diabetes associated with generalised obesity in 1994, 1998 and 2003 were 1.62, 2.26 and 2.62, respectively, in women and 1.24, 1.82 and 2.10, respectively, in men. Similar differences were observed for hypertension and HDC. Men and women with abdominal obesity also showed a higher risk for diabetes, hypertension and HDC than those with a normal WC.

Conclusions

If current trends in obesity continue then the risk of related morbidities may also increase. This will impact on cardiovascular disease morbidity and mortality, with cost implications for the health service. Therefore there is an urgent need to control the epidemic of obesity.

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Corresponding author
Corresponding author: Email v.hirani@ucl.ac.uk
References
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1 World Health Organization. Obesity and overweight [online], 2006. Available at http://www.who.int/dietphysicalactivity/publications/facts/obesity/en/. Accessed 20 September 2006.
2 Department of Health. Health Survey for England – trend data [online], undated. Available at http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/health-survey-for-england. Accessed August 2007.
3 Sproston K, Primatesta P, eds. Health Survey for England 2003. London: The Stationery Office, 2004.
4 Jonsson S, Hedblad B, Engstrom G, Nilsson P, Berglund G, Janzon L. Influence of obesity on cardiovascular risk. Twenty-three-year follow-up of 22,025 men from an urban Swedish population. International Journal of Obesity and Related Metabolic Disorders 2002; 8: 10461053.
5 Okosun IS, Chandra KM, Choi S, Christman J, Dever GE, Prewitt TE. Hypertension and type 2 diabetes co-morbidity in adults in the United States: risk of overall and regional adiposity. Obesity Research 2001; 9: 19.
6 Weir MR. Diabetes and hypertension: blood pressure control and consequences. American Journal of Hypertension 1999; 12: 170S178S.
7 Huang Z, Willett WC, Manson JE, Rosner B, Stampfer MJ, Speizer FE, et al. Body weight, weight change, and risk for hypertension in women. Annals of Internal Medicine 1998; 128: 8188.
8 Epstein M, Sowers JR. Diabetes mellitus and hypertension. Hypertension 1992; 19: 403418.
9 Kopelman PG. Obesity as a medical problem. Nature 2000; 404: 635643.
10 Gensini GF, Comeglio M, Colella A. Classical risk factors and emerging elements in the risk profile for coronary artery disease. European Heart Journal 1998; 19 (Suppl. A): A5361.
11 Garrow J. Body composition for the investigation of obesity. Basic Life Sciences 1990; 55: 183190.
12 Stamatelopoulos KS, Lekakis JP, Vamvakou G, Katsichti P, Protogerou A, Revela I, et al. The relative impact of different measures of adiposity on markers of early atherosclerosis. International Journal of Cardiology 2007; 119: 139146.
13 International Diabetes Federation (IDF). IDF consensus worldwide definition of the metabolic syndrome [online], 2006. Available at http://www.idf.org/webdata/docs/IDF. Accessed 10 September 2006.
14 Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet 2005; 365: 14151428.
15 International Obesity Task Force. About Obesity [online], June 2007. Available at http://www.iotf.org/aboutobesity.asp. Accessed August 2007.
16 Department of Health. Health Survey for England (HSE) 2003. Methodology and documentation report [online], 2004. Available at http://www.archive2.officialdocuments.co.uk/document/deps/doh/survey03/md/md.htm. Accessed 10 May 2006.
17 National Institutes of Health (NIH). Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). NIH Publication 01-3670. Bethesda, MD: NIH, 2001.
18 Rossner S. Obesity: the disease of the twenty-first century. International Journal of Obesity and Related Metabolic Disorders 2002; 26 (Suppl. 4): S24.
19 Walker SP, Rimm EB, Ascherio A, Kawachi I, Stampfer MJ, Willett WC. Body size and fat distribution as predictors of stroke among US men. American Journal of Epidemiology 1996; 144: 11431150.
20 Molarius A, Seidell JC. Selection of anthropometric indicators for classification of abdominal fatness – a critical review. International Journal of Obesity and Related Metabolic Disorders 1998; 22: 719727.
21 Sjostrom L. Obesity and its relationship to other diseases. In: Shetty PS, McPherson K, eds. Diet, Nutrition and Chronic Disease: Lessons from Contrasting Worlds. LSHTM Sixth Annual Public Health Forum. London: Wiley, 1996; 235239.
22 Harris MM, Stevens J, Thomas N, Schreiner P, Folsom AR. Associations of fat distribution and obesity with hypertension in a bi-ethnic population: the ARIC study. Atherosclerosis Risk in Communities Study. Obesity Research 2000; 8: 516524.
23 Faria AN, Ribeiro Filho FF, Gouveia Ferreira SR, Zanella MT. Impact of visceral fat on blood pressure and insulin sensitivity in hypertensive obese women. Obesity Research 2002; 10: 12031206.
24 Carey D, Jenkins AB, Campbell LV, Freund J, Chisholm DJ. Abdominal fat and insulin resistance in normal and overweight women: direct measures reveal a strong relationship in subjects at both low and high risk of NIDDM. Diabetes 1996; 45: 633638.
25 Kanai H, Matsuzawa Y, Kotani K, Keno Y, Kobatake T, Nagai Y, et al. Close correlation of intra-abdominal fat accumulation to hypertension in obese women. Hypertension 1990; 16: 484490.
26 Manson JE, Willett WC, Stampfer MJ, Colditz GA, Hunter DJ, Hankinson SE, et al. Body weight and mortality among women. New England Journal of Medicine 1995; 333: 677685.
27 Siani A, Cappuccio FP, Barba G, Trevisan M, Farinaro E, Lacone R, et al. The relationship of waist circumference to blood pressure: the Olivetti Heart Study. American Journal of Hypertension 2002; 15: 780786.
28 Department of Health. Choosing Health: Making Healthy Choices Easier [online], 2004. Available at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4094550. Accessed 10 July 2006.
29 Department of Health. Delivering Choosing Health: Making Healthier Choices Easier [online], 2005. Available at http://www.dh.gov.uk/assetRoot/04/10/57/13/04105713.pdf. Accessed 10 September 2006.
30 Department of Health. Choosing a Better Diet: A Consultation on Priorities for a Food and Health Action Plan [online], 2003. Available at http://www.dh.gov.uk/assetRoot/04/06/58/34/04065834.pdf. Accessed 10 September 2006.
31 Department of Health. Choosing Activity: A Physical Activity Action Plan [online], 2005. Available at http://www.dh.gov.uk/assetRoot/04/10/57/10/04105710.pdf. Accessed 10 July 2006.
32 Pi-Sunyer FX. Short-term medical benefits and adverse effects of weight loss. Annals of Internal Medicine 1993; 119: 722726.
33 Huang Z, Reddy A. Weight change, ideal weight and hypertension. Current Opinions in Nephrology and Hypertension 1999; 8: 343346.
34 Staessen J, Fagard R, Lijnen P, Amery A. Body weight, sodium intake, and blood pressure. Journal of Hypertension 1989; 7 (Suppl.): S1923.
35 Broom J. Systematic review of the long-term effects and economic consequences of treatments for obesity and implications for health improvement. The Research Findings Register [online], 2004. Available at http://www.ReFeR.nhs.uk/ViewRecord.asp?ID=1274. Accessed 15 July 2006.
36 Hill JO, Wyatt HR, Reed GW, Peters JC. Obesity and the environment: where do we go from here? Science 2003; 299: 853855.
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