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

ObjectiveWhether obesity without metabolic syndrome (i.e., metabolically healthy obesity) confers similar or less metabolic risk remains controversial. MethodsA retrospective 5-year cohort study of 9,721 Japanese subjects (48.510.5 years, 4,160 men) was conducted in 2004 and reevaluated 5 years later. Subjects were excluded if they were hypertensive or diabetic or were receiving medications for dyslipidemia and/or gout or hyperuricemia in 2004. Study subjects were categorized according to baseline BMI 25 kg/m(2) (overweight/obesity) and<25 kg/m(2) (lean/normal weight) and also whether they had metabolic syndrome. The cumulative incidence of hypertension and diabetes over 5 years between groups was assessed. A second analysis evaluated whether baseline hyperuricemia provided additional risk. ResultsSubjects with overweight/obesity but without metabolic syndrome carried increased cumulative incidence 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%). ConclusionsMetabolically healthy obesity and hyperuricemia confer increased risk for hypertension and diabetes.