“This [geographic distribution] is important because these processes can be precursors to diabetes and cardiovascular disease. These data provide an important indication of where preventive efforts could be focused to avoid diabetes and cardiovascular disease in these regions,” Mark D. DeBoer, MD, MSc, MCR, associate professor in the division of pediatric endocrinology at the University of Virginia, told Endocrine Today.
DeBoer and colleagues analyzed data from 9,824 adults aged 20 to 65 years participating in the 1999-2014 waves of the National Health and Nutrition Examination Survey. Participants completed questionnaires and underwent measurements of waist circumferences, blood pressure, fasting triglycerides, HDL cholesterol and fasting glucose. Researchers estimated rates of obesity, diabetes and metabolic syndrome across nine U.S. census divisions: New England, Mid-Atlantic, East North Central, West North Central, South Atlantic, East South Central, West South Central, Mountain and Pacific. Rates stratified by sex and race were reported across the four census regions: Northeast, Midwest, South and West.
Researchers found that obesity prevalence overall was highest in the West South Central and East South Central divisions (37.5% and 37.2%, respectively), and lowest in the Mountain and New England divisions (26.7% and 28.7%, respectively). Overall prevalence of metabolic syndrome was highest in the West North Central division (40%) and lowest in the Pacific and New England divisions (29% and 29.2%, respectively). Diabetes prevalence overall was highest in the East South Central and West North Central divisions (9.4% and 9%, respectively) and lowest in the New England division (4.5%).
Researchers also observed variations in obesity, diabetes and metabolic syndrome by sex and race across regions — the most notable differences among white adults, they wrote. White women, for example, had a low prevalence of obesity, diabetes and metabolic syndrome in the Northeast and West regions, and white men had a low prevalence of all three conditions in the West region. However, in the Midwest region, where white adults make up 87% of the population, white men and women had a high prevalence of obesity (men, 34.2%; women, 35.2%), metabolic syndrome (men, 34.2%; women, 35.2%) and diabetes (men, 10.3%; women, 7%).
Black men had a high prevalence of metabolic syndrome in the West region (32.6%), but a low prevalence of metabolic syndrome elsewhere, according to researchers; however, diabetes prevalence was high for black men across all regions (8.7% to 12.7%). In three of the four census regions — the West, Midwest and Northeast —black women had the highest prevalence of metabolic syndrome among all women (30.9%, 36% and 36.7%, respectively).
“Further assessments are needed to determine lifestyle and other causes of the increased prevalence of obesity and metabolic syndrome in these geographical areas and whether focused attention can help avoid worsened cardiovascular disease in these populations,” DeBoer said. – by Regina Schaffer