Association of Hypertension, Diabetes, Dyslipidemia, and Metabolic Syndrome with Obesity: Findings from the National Health and Nutrition Examination Survey, 1999 to 2004

BACKGROUND: Hypertension, diabetes, and dyslipidemia are common conditions associated with obesity. This study provides current estimates of the prevalence of hypertension, diabetes, dyslipidemia, and Metabolic syndrome according to the severity of obesity in men and women participating in the 1999 to 2004 National Health and Nutrition Examination Survey (NHANES). STUDY DESIGN: Data from a representative sample of 13,745 US men and women who participated in the NHANES between 1999 and 2004 were reviewed. Overweight and obesity classes 1, 2, and 3 were defined as a body mass index of 25.0 to 29.9, 30.0 to 34.9, 35.0 to 39.9, and >= 40.0 kg/m(2), respectively. Metabolic syndrome was defined according to the 2004 National Heart, Lung and Blood Institute/American Heart Association conference proceedings. RESULTS: With increasing overweight and obesity class, there is an increase in the prevalence of hypertension (18.1% for normal weight to 52.3% for obesity class 3), diabetes (2.4% for normal weight to 14.2% for obesity class 3), dyslipidemia (8.9% for normal weight to 19.0% for obesity class 3), and metabolic syndrome (13.6% for normal weight to 39.2% for obesity class 3). With normal weight individuals as a reference, Individuals with obesity class 3 had an adjusted odds ratio of 4.8 (95% CI 3.8 to 5.9) for hypertension, 5.1 (95% CI 3.7 to 7.0) for diabetes, 2.2 (95% CI 1.7 to 2.4) for dyslipidemia, and 2.0 (95% CI 1.4 to 2.8) for metabolic syndrome. CONCLUSIONS: The prevalence of hypertension, diabetes, dyslipidemia, and metabolic syndrome substantially increases with increasing body mass index. These findings have important public health implications for the prevention and treatments (surgical and nonsurgical) of obesity (J Am Coll Surg 2008;207:928-934. (C) 2008 by the American College of Surgeons)