1. All racial/ethnic minority groups evaluated, compared with Caucasian patients, had a statistically higher prevalence of metabolic abnormality but normal body weight (MAN).
2. Using BMI as a method of screening for increased cardiometabolic risk may leave out a significant proportion of vulnerable patients.
Evidence Rating Level: Good (2)
Study Rundown: Body weight is a common method used to screen for cardiometabolic disease, as overweight and obesity are well-known risk factors. However, patients with a healthy weight may also have increased cardiometabolic risk. It has been suggested that the relationship between obesity and cardiometabolic abnormalities may vary among ethnic groups. The authors of this study aimed to determine the prevalence and correlates of the phenotype of metabolic abnormality but normal weight (MAN) for 5 racial/ethnic groups. In general, they observed that minority groups had a higher prevalence of MAN. This study has several limitations. Specifically, there are differences in timing of data collection between studies used, which may have resulted in differences in the prevalence of overweight and obesity between the 2 cohorts. Overall, this study suggests that an alternative-screening tool for cardiometabolic risk may be more appropriate in order to avoid missing patients with normal body weights but increased risk.
In-Depth [retrospective cohort]: The authors of this study conducted a cross-sectional analysis using 2 community-based cohorts, MESA (Multi-Ethnic Study of Atherosclerosis) and the MASALA (Mediators of Atherosclerosis in South Asians Living in America). Statistics were calculated using pooled data from the two cohorts. In general, there was an increased prevalence of MAN in all 5 racial/ethnic groups compared to white patients. Specifically, the prevalence of MAN was 21.0% (95% CI, 18.4%-23.9%) in whites, 32,2% (CI, 27.3% to 37.4%) in Chinese Americans, 31.1% (CI, 26.3% to 36.3%) in African Americans, 38.5% (CI, 32.6% to 44.6%) in Hispanics, and 43.6% (CI, 36.8% to 50.6%) in South Asians.
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