Impact of body mass index on the incidence of cardiometabolic risk factors in ambulatory care settings over 5 years or more

Abstract

Objective: This study was performed to evaluate the association of body mass index (BMI) with the incidence of cardiometabolic risk factors in ambulatory care electronic medical records (EMRs) over 5 years or more. Design: A retrospective cohort of normal versus obese patients. Subjects: Subjects ≥18 years were identified between 1996 and 2005. Measurements: Patients were categorized as either normal weight (18 kg/m2 27 kg/m2) based on baseline BMI (measured 395 days or more after first EMR activity). Outcomes included development, at least 180 days after the first BMI reading date, of four cardiometabolic risk factors (elevated triglycerides, low high-density lipoprotein cholesterol [HDL-C], hypertension, or type 2 diabetes) determined from ICD-9 code, prescribed drug, or biometric reading. Logistic regression estimated the odds of developing cardiometabolic risk factors, alone and combined for normal versus obese patients forward for at least 5 years. Results: Seventy-one percent were female, mean age was 43.5 years, and 37.6% had a baseline BMI > 27 kg/m2. Comparing obese versus normal weight patients, adjusted odds ratios for the incidence of elevated triglycerides, hypertension, diabetes, and low HDL-C were 2.1 (95% confidence interval [95% CI] 1.9-2.3), 2.2 (95% CI 2.1-2.4), 2.3 (95% CI 2.0-2.7), and 2.2 (95% CI 2.0-2.4), respectively. Adjusted odds ratios of developing one and all four new risk factors were 1.9 (95% CI 1.8-2.1) and 7.9 (95% CI 5.9-10.5), respectively. Conclusion: Obese patients are approximately twice as likely to develop cardiometabolic risk factors compared with those having normal weight over 5 or more years. © 2009, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).