Prevalence of metabolic conditions by BMI category and undiagnosed status in the U.S Adults

Introduction Obesity is a risk factor for abnormal metabolic conditions including hypertension, high cholesterol and type 2 diabetes (T2D). The varying prevalence patterns of these metabolic conditions stratified by body mass index (BMI) among individuals lacking awareness of their disease status is poorly explored. Methods The study data was from the U.S. CDC 2013-2014 National Health and Nutrition Examination Survey and included participants aged ≥20 years who had completed examinations for blood pressure and BMI, laboratory tests for blood sugar and cholesterol, and interviews for demographics and other related health issues. Individuals lacking a formal diagnosis from a health professional were referred to as undiagnosed. The weighted prevalence and its 95% confidence interval (CI) for total T2D, hypertension, and high cholesterol and total abnormal metabolic items by BMI within each subgroup were calculated. Similar calculations were also applied to undiagnosed participants. By treating BMI \u3c 25 as the reference, the proportional test was used to identify if significant prevalence existed in two comparisons:overweight vs. BMI \u3c 25 and obese vs. BMI \u3c 25. A p \u3c 0.05 was considered statistically significant Results and Conclusions The overall weighted prevalence of diabetes, hypertension, high cholesterol and overall abnormal metabolic conditions were 16.1%, 60.3%, 57.5% and 76.3%, respectively while the prevalence of undiagnosed diabetes, hypertension, high cholesterol and abnormal metabolic condition are 8.8%, 11.3%, 16.8% and 30.2%, respectively. A higher prevalence of T2D existed in individuals with BMI25≤BMI≤30 among black adults (18.4% vs. 16.2%). Similar differences were also observed among undiagnosed black participants with BMI \u3c 25 (12.1% vs. 7.5%). The prevalence of total and undiagnosed hypertension increased with BMI although prevalence was lower in the undiagnosed population. Our study findings reveal that while a higher proportion of obese individuals have chronic conditions, a large proportion of normal weight individuals are similarly burdened. The prevalence estimates of individuals with at least one undiagnosed abnormal metabolic condition indicates a need for expanded screening campaigns. Additionally, the higher prevalence of T2D among normal weight warrants further research to identify potential drivers. Although efforts to manage and control these conditions must continue to have a heightened focus on obese individuals, it must also broaden its scope to target normal weight individuals and develop strategies to decrease the proportion of U.S adults without awareness of their disease status