BMI ≥25.0 and WC ≥90 are components of the International Diabetes Federation (IDF) definition of metabolic syndrome for Asians. We have investigated more suitable BMI and WC levels for risk of CAD using large-scale nationwide claims data on people with and without DM in the same cohort. The sample included 157,220 Japanese men 18-72 years of age without a known history of CAD at baseline (DM: 15,465 patients, non-DM: 141,755 patients). Multivariate Cox regression model examined the association of BMI/WC categories and their combination with CAD. During the study period (median follow-up 5.3 y), 662 and 332 CAD events occurred in non-DM and DM, respectively. Cox regression model showed that BMI ≥22.5 and WC ≥80 conferred a 1.29 (1.07-1.55), and 1.23 (1.00-1.50) times increased risk of CAD, respectively, in non-DM but that those relationships disappeared in people with DM (HR, 0.96 (0.71-1.29) for BMI and 1.13 (0.78-1.62) for WC. Stratified analysis of 4 groups of combinations of BMI and WC showed that in non-DM with BMI ≥22.5/WC ≥80 the risk of future CAD was significantly increased compared with non-DM with BMI<22.5/WC<80 (Table). Each DM group had an approximately 3-fold increase in CAD events (Table).
In summary, lower BMI and WC values can predict CAD in individuals without DM whereas their influence was modest in people with DM.
T. Komatsu: None. K. Fujihara: None. M.H. Yamada: None. T. Sato: None. M. Kitazawa: None. M. Yamamoto: None. H. Seida: None. N. Yamanaka: None. Y. Matsubayashi: None. T. Yamada: None. H. Sone: Research Support; Self; Kyowa Hakko Kirin Co., Ltd., Novartis AG, Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co.