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American Journal of Epidemiology 2005 162(1):42-48; doi:10.1093/aje/kwi166
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved

ORIGINAL CONTRIBUTIONS

Body Mass Index and Incident Ischemic Heart Disease in South Korean Men and Women

Sun Ha Jee1, Roberto Pastor-Barriuso2, Lawrence J. Appel3,4,5, Il Suh6, Edgar R. Miller, III3,4,5 and Eliseo Guallar3,4

1 Department of Epidemiology and Disease Control, Graduate School of Health Science and Management, Yonsei University, Seoul, Republic of Korea
2 Division of Biostatistics, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
3 Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD
4 Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
5 Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD
6 Department of Preventive Medicine and Public Health, College of Medicine, Yonsei University, Seoul, Republic of Korea

Correspondence to Dr. Eliseo Guallar, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 2024 East Monument Street, Room 2-639, Baltimore, MD 21205 (e-mail: eguallar{at}jhsph.edu).

Asian populations have a higher body fat percentage for a given body mass index (BMI) than Caucasians. However, little information is available on the association of BMI with ischemic heart disease (IHD) incidence in Asians at low BMI levels. The authors prospectively evaluated the association of BMI (weight (kg)/height (m)2) with IHD incidence over 9 years of follow-up (1993–2001) among 133,740 South Korean adults (89,050 men, 44,690 women) who participated in the 1990 and 1992 examinations of the Korea Medical Insurance Corporation Study. Average BMI at baseline was 23.4 (standard deviation, 2.3) in men and 22.3 (standard deviation, 2.3) in women. After multivariate adjustment, there was a 14% (95% confidence interval: 12, 16) increased risk of incident IHD per unit of increase in BMI. This trend was also observed within the range considered normal by Western standards, and a BMI of 24–<25 was associated with an IHD hazard ratio of 2.01 (95% confidence interval: 1.32, 3.05) in comparison with a BMI of 18–<19. The association of BMI with IHD in this cohort of relatively young South Korean men and women was progressive over the range of BMI values, with no threshold of change in risk and no indication of a U-shaped relation at low BMI levels.

Asian continental ancestry group; body mass index; body weight; myocardial ischemia; obesity


Abbreviations: BMI, body mass index; CI, confidence interval; KMIC, Korea Medical Insurance Corporation


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