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Obesity: Special Feature |
Department of Medicine/Nephrology, Thomas Jefferson University (B.F.), Philadelphia, Pennsylvania 19107; and IMS Health (N.C.), Blue Bell, Pennsylvania 19422
Address all correspondence and requests for reprints to: Bonita Falkner, M.D., Division of Nephrology, Thomas Jefferson University, 833 Chestnut Street, Suite 700, Philadelphia, Pennsylvania 19107. E-mail: bonita.falkner{at}jefferson.edu.
The prevalence of obesity is increasing among all age and racial groups in the United States. There is, however, a disproportionate rise in the prevalence of obesity among African-Americans and Hispanic/Mexican Americans. Obesity is a major contributor to the insulin resistant syndrome (IRS), a condition of multiple metabolic abnormalities that is a precursor to type 2 diabetes, and confers a high risk for cardiovascular events. The estimated prevalence of IRS is also greater in Mexican Americans and African-Americans than in Caucasians. The IRS is identifiable in children, and as with adults, there are racial differences in its expression even at a young age. The obesity-associated diseases, including diabetes and hypertension, are found at higher rates within the minority races compared with Caucasians. However, there are differences, in that obesity-related hypertension occurs at higher rates among African-Americans, and obesity-related diabetes occurs at higher rates among Mexican Americans. Race/ethnic differences in lifestyle behaviors and economic disadvantage may account for some of the race disparity in obesity-related diseases and disease outcomes. Environmental factors, however, do not explain all of the race disparity in disease expression, indicating that there are genetic/molecular factors that are operational as well.
Abbreviations: BMI, Body mass index; HDL, high density lipoprotein; IRS, insulin resistant syndrome; NHANES, National Health and Nutrition Examination Survey; VAT, visceral adipose tissue.
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