Body mass index and incident ischemic heart disease in South Korean men and women

Department of Epidemiology and Disease Control, Graduate School of Health Science and Management, Yonsei University, Seoul, Republic of Korea.
American Journal of Epidemiology (Impact Factor: 5.23). 08/2005; 162(1):42-8. DOI: 10.1093/aje/kwi166
Source: PubMed


Asian populations have a higher body fat percentage for a given body mass index (BMI) than Caucasians. However, little information is available on the association of BMI with ischemic heart disease (IHD) incidence in Asians at low BMI levels. The authors prospectively evaluated the association of BMI (weight (kg)/height m2) with IHD incidence over 9 years of follow-up (1993-2001) among 133,740 South Korean adults (89,050 men, 44,690 women) who participated in the 1990 and 1992 examinations of the Korea Medical Insurance Corporation Study. Average BMI at baseline was 23.4 (standard deviation, 2.3) in men and 22.3 (standard deviation, 2.3) in women. After multivariate adjustment, there was a 14% (95% confidence interval: 12, 16) increased risk of incident IHD per unit of increase in BMI. This trend was also observed within the range considered normal by Western standards, and a BMI of 24-<25 was associated with an IHD hazard ratio of 2.01 (95% confidence interval: 1.32, 3.05) in comparison with a BMI of 18-<19. The association of BMI with IHD in this cohort of relatively young South Korean men and women was progressive over the range of BMI values, with no threshold of change in risk and no indication of a U-shaped relation at low BMI levels.

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Available from: Eliseo Guallar, Jul 03, 2014
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    • "There also appears to be a linear relationship between BMI and coronary heart disease (CHD), which is particularly evident among Asian populations. Jee and colleagues published a detailed analysis of BMI and CHD incidence among 133 740 Korean participants during nine years of follow-up (Jee et al., 2005). After adjustment for age, sex, and smoking status, each 1-unit increase in BMI was associated with a 14% (95% CI, 12–16%) increased risk of incident CHD. "
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    ABSTRACT: Excess body weight and adiposity cause insulin resistance, inflammation, and numerous other alterations in metabolic and hormonal factors that promote atherosclerosis, tumorigenesis, neurodegeneration, and aging. Studies in both animals and humans have demonstrated a beneficial role of dietary restriction and leanness in promoting health and longevity. Epidemiological studies have found strong direct associations between increasing body mass index (BMI) and risks of developing type 2 diabetes, cardiovascular disease, and several types of cancer, beginning from BMI of 20–21 kg m−2. Although a recent meta-analysis suggests that overweight individuals have significantly lower overall mortality than normal-weight individuals, these data are likely to be an artifact produced by serious methodological problems, especially confounding by smoking, reverse causation due to existing chronic disease, and nonspecific loss of lean mass and function in the frail elderly. From a clinical and public health point of view, maintaining a healthy weight through diet and physical activity should remain the cornerstone in the prevention of chronic diseases and the promotion of healthy aging.
    Aging cell 03/2014; 13(3). DOI:10.1111/acel.12207 · 6.34 Impact Factor
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    • "Thus, our findings provide evidence for the importance of greater adiposity in the occurrence of a CHD event. In other studies that investigated the association between BMI and incident CHD [9,12-15,17,37], results were broadly similar to those found here, but generally lacked power to describe reliably the relation between BMI and incident CHD across a wide range of values and important subgroups in the population. "
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    ABSTRACT: Background A high body mass index (BMI) is associated with an increased risk of mortality from coronary heart disease (CHD); however, a low BMI may also be associated with an increased mortality risk. There is limited information on the relation of incident CHD risk across a wide range of BMI, particularly in women. We examined the relation between BMI and incident CHD overall and across different risk factors of the disease in the Million Women Study. Methods 1.2 million women (mean age = 56 years) participants without heart disease, stroke, or cancer (except non-melanoma skin cancer) at baseline (1996 to 2001) were followed prospectively for 9 years on average. Adjusted relative risks and 20-year cumulative incidence from age 55 to 74 years were calculated for CHD using Cox regression. Results After excluding the first 4 years of follow-up, we found that 32,465 women had a first coronary event (hospitalization or death) during follow-up. The adjusted relative risk for incident CHD per 5 kg/m2 increase in BMI was 1.23 (95% confidence interval (CI) 1.22 to 1.25). The cumulative incidence of CHD from age 55 to 74 years increased progressively with BMI, from 1 in 11 (95% CI 1 in10 to 12) for BMI of 20 kg/m2, to 1 in 6(95% CI 1 in 5 to 7) for BMI of 34 kg/m2. A 10 kg/m2 increase in BMI conferred a similar risk to a 5-year increment in chronological age. The 20 year cumulative incidence increased with BMI in smokers and non-smokers, alcohol drinkers and non-drinkers, physically active and inactive, and in the upper and lower socioeconomic classes. In contrast to incident disease, the relation between BMI and CHD mortality (n = 2,431) was J-shaped. For the less than 20 kg/m2 and ≥35 kg/m2 BMI categories, the respective relative risks were 1.27 (95% CI 1.06 to 1.53) and 2.84 (95% CI 2.51 to 3.21) for CHD deaths, and 0.89 (95% CI 0.83 to 0.94) and 1.85 (95% CI 1.78 to 1.92) for incident CHD. Conclusions CHD incidence in women increases progressively with BMI, an association consistently seen in different subgroups. The shape of the relation with BMI differs for incident and fatal disease.
    BMC Medicine 04/2013; 11(1):87. DOI:10.1186/1741-7015-11-87 · 7.25 Impact Factor
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    • "We demonstrated that obesity is closely related to type 2 diabetes, hypertension, and hypercholesterolemia in Koreans using 812,251 data with eight years of follow-up [4]. Other Korean researchers have demonstrated a clear dose-dependent relationship between obesity, ischemic heart disease [13] and stroke [14]. "
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