“Metabolically Healthy” Obesity and Hyperuricemia Increase Risk for Hypertension and Diabetes: 5‐year Japanese Cohort Study

Abstract

Objective Whether obesity without metabolic syndrome (i.e., “metabolically healthy” obesity) confers similar or less metabolic risk remains controversial. Methods We conducted a retrospective 5-year cohort study of 9,721 Japanese subjects (48.5±10.5 years, 4,160 men) in 2004 and reevaluated 5 years later. Subjects were excluded if they were hypertensive, diabetic, or were receiving medications for dyslipidemia and/or gout or hyperuricemia in 2004. Study subjects were categorized according to baseline BMI of ≥25 kg/m2(overweight/obesity) and <25 kg/m2(lean/normal) and also whether they had metabolic syndrome. The cumulative incidences of hypertension and diabetes over 5 years between groups were assessed. A second analysis evaluated whether baseline hyperuricemia provided additional risk. Results Subjects with overweight/obesity but without metabolic syndrome carried increased cumulative incidences of hypertension(14.6% vs 7.2%, p<0.001) and diabetes(2.6% vs 1.1%, p=0.004) over 5 years compared to lean/normal subjects without metabolic syndrome. Overweight/obesity conferred an increased risk for diabetes even in individuals with normal fasting blood glucose. Hyperuricemia became an independent risk factor for developing hypertension over 5 years in lean/normal subjects without metabolic syndrome. A 1 mg/dL increase in serum uric acid carried increased risk for hypertension(19%) and diabetes(27%). Conclusions “Metabolically healthy” obesity and hyperuricemia confers increased risk for hypertension and diabetes.

Cross-sectional study of associations between normal body weight with central obesity and hyperuricemia in Japan

“…Several studies have investigated serum uric acid levels in Japanese adults. Reported serum uric acid levels for men and women are respectively, 6.2 and 4.4 mg/dL [13], 5.9 and 4.2 mg/dL [14], 6.5 and 4.7 mg/dL [15], and 6.0 and 4.5 mg/dL [21]. Therefore, our findings of higher serum acid levels in men were similar to these findings.…”

“…Hyperuricemia was defined as serum uric acid >7.0 mg/dL in men or ≥6.0 mg/dL in women, or being under medical treatment for hyperuricemia [12][13][14][15]. The definition in men was based on Japanese guidelines for the management of hyperuricemia [12].…”

“…Serum uric acid levels are lower in women than in men because female hormones decrease them [16,17]. Thus, we defined hyperuricemia in women as ≥6.0 mg/dL [13][14][15]. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or under medication for hypertension [18].…”

Cross-sectional study of associations between normal body weight with central obesity and hyperuricemia in Japan

“…Serum uric acid levels are lower in women than in men because female hormones decrease them [17,18]. These cutoff values were selected as they are generally used in clinical laboratories and have been proposed in previous studies in relation to metabolic syndrome and CVD outcomes to define hyperuricemia [13][14][15][16]19].…”

The Role of Hyperuricemia in Human Morbidity, and Treatment Options

“…В 5-летнем ретроспективном исследовании с включением 9721 японца (представители обоих полов; средний возраст -48,5 ± 10,5 года) показано сочетание метаболически здорового ожирения и ГУ в качестве предиктора развития гипертензии и сахарного диабета 2 типа [65].…”