Differences in the relationship between lipid CHD risk factors and body composition in Caucasians and Japanese

Abstract

OBJECTIVES: To examine differences in the relationship between fat distribution and lipid coronary risk factors in Caucasian and Japanese population and further to determine whether the cut-points for body mass index (BMI) and waist circumference (WC) proposed by WHO and NHLBI are applicable to Japanese population as a predictor of a lipid risk factor abnormality or not. RESEARCH METHODS AND PROCEDURES: Subjects were 895 participants of the Baltimore Longitudinal Study of Aging in the US (BLSA) and 1705 participants of the Longitudinal Study of Aging by the National Institutes for Longevity Science in Japan (NILS-LSA). Subjects were divided into four demographic groups as younger (ageo65 y) men and women, and older (ageZ65 y) men and women. Blood total cholesterol, triglycerides, LDL-and HDL-cholesterol and anthropometry were measured. Regression coefficients of BMI and WC on risk factors, sensitivity and specificity of the BMI and WC cut-points for blood lipid abnormality, and mean values of blood lipids at BMI or WC cut-points were computed in both populations. RESULTS: Height, weight, WC and BMI were significantly greater in the BLSA than those in the NILS-LSA subjects. Total cholesterol, HDL-and LDL-cholesterol were significantly greater in the NILS-LSA than in the BLSA subjects. Sensitivities of BMI and WC cut-points were much lower in the NILS-LSA than in the BLSA subjects. Specificities of BMI and WC cut-points were higher in the NILS-LSA than in the BLSA subjects. Mean values of triglycerides, total cholesterol, HDL-and LDL-cholesterol at BMI ¼ 25 were significantly greater in the NILS-LSA than in the BLSA subjects. At the WC cut-point (94 cm for men, 80 cm for women), mean values of all lipids were significantly greater in the NILS-LSA than in the BLSA subjects with the exception of triglycerides in younger women. CONCLUSIONS: The Japanese subjects have smaller BMI and WC, worse total and LDL-cholesterol levels and better HDLcholesterol levels compared to Caucasians. Sensitivities of BMI and WC for predicting lipid risk factor abnormality are much lower in Japanese. The cut-points for BMI and WC proposed by WHO and NHLBI may be too high for predicting an abnormality in triglycerides, total and LDL-cholesterol in Japanese. For detecting an abnormal HDL-cholesterol level, the BMI and WC cutpoints may not be as beneficial for the Japanese population as for Caucasians.

Lower HDL-cholesterol among healthy middle-aged Japanese-Brazilians in São Paulo compared to Natives and Japanese-Brazilians in Japan

“…Levels of HDLcholesterol in the Japanese population are higher than those reported in Caucasian populations [4,5]. This favorable lipid profile may be one of the explanations for the lower morbidity of CHD in Japanese populations [6].…”

Plasma adipocytokines and antioxidants-status in Korean overweight and obese females with dyslipidemia

“…WHO Expert Consultation suggested lower BMIs cut-off point at 23 for overweight in Asian population, in comparison to western BMI cut-off points for overweight (BMI ≥ 23 kg/m 2 ) [25]. A study reported that this lowered BMI as a cut-off point for overweight in Asian population was suitable because this BMI value is significantly associated with risks of chronic diseases [26]. …”

Relationship between BMI and body fatness in three European countries

“…9,21 Alternatively, it has been suggested to use waist circumference as a better predictor of disease risk than BMI within populations. 4,22 In the study by Iwao et al 13 Japanese subjects had smaller BMI and waist circumference but worse total and low-density lipoprotein-cholesterol levels compared with Caucasians. 13 In our study, Irish subjects had (or tended to have) higher blood lipids compared with Spanish or Icelandic subjects, but in contrast to the above study, increased waist circumference in the Irish subjects explained much of the unfavorable cardio-metabolic risk profile.…”

“…4,22 In the study by Iwao et al 13 Japanese subjects had smaller BMI and waist circumference but worse total and low-density lipoprotein-cholesterol levels compared with Caucasians. 13 In our study, Irish subjects had (or tended to have) higher blood lipids compared with Spanish or Icelandic subjects, but in contrast to the above study, increased waist circumference in the Irish subjects explained much of the unfavorable cardio-metabolic risk profile. It is known that increased visceral fat negatively affects metabolic profiles by releasing free fatty acids and adipokines and as a consequence it increases diabetes and heart disease risk.…”

“…Several studies have reported this in Asian, African and indigenous populations, often compared with Caucasians. [7][8][9][10][11][12][13] However, information is lacking on differences between, for example, various Caucasian populations within Europe.…”