Trends in Cardiometabolic Risk Prevalence among US Young Adults, NHANES 1999-2014 Público

Abstract

Objectives. This study aimed to characterize the cardiometabolic risk profile for the United States (US) young adult population over the 1999-2014 period, assess trends in prevalence over four survey periods, and identify the subgroups experiencing the biggest increases in cardiometabolic risk in this population.

Methods. We analyzed data for 21,655 young adults, aged 18-44 years, from the National Health and Nutrition Examination Survey (NHANES). We estimated prevalence of diabetes, prediabetes, hypertension, prehypertension, high non-HDL cholesterol, current smoking, obesity, overweight, central obesity, and central adiposity. We used multivariate logistic regression to compute prevalence estimates (predictive margins) adjusted for sex, race/ethnicity, educational attainment, marital status, and insurance coverage. We calculated absolute percentage changes in prevalence (and 95% confidence intervals [CI]) across sociodemographic subgroups from 1999-2002 to 2011-2014 and compared them using t-tests.

Results. Among US young adults, diabetes prevalence increased from 2.65% (95% CI: 2.15-3.28) in 1999-2002 to 4.03% (3.50-4.64) in 2011-2014, while prediabetes more than doubled from 4.69% (3.72-5.89) to 11.11% (10.00-12.34). Prevalence of obesity (26.41% [24.74-28.16] to 33.98% [31.94-36.09]) and central obesity (11.90% [10.52-13.44] to 19.27% [17.42-21.20]) also increased. In contrast, prehypertension declined from 27.15% (25.52-28.84) to 22.55% (21.02-24.15), as did smoking (39.90% [36.56-43.34] to 32.19% [29.9-34.56]). There were no changes in hypertension or high non-HDL cholesterol. Diabetes prevalence significantly increased among women, Mexican Americans, high school graduates, married young adults, and PIR group <1.0. Prediabetes increased across all subgroups, especially among non-Hispanic blacks, Mexican Americans, those with less than high school education, married, and uninsured young adults. Increases in obesity were greatest among sociodemographic subgroups similar to diabetes and prediabetes.

Conclusions. US young adults had significant increases in prevalence of diabetes, prediabetes, obesity, and central obesity from 1999 to 2014, with simultaneous decreases in prehypertension and smoking. Public health efforts should be targeted towards women, non-Hispanic black and Mexican American young adults, those with a high school education or less, low- and middle-income young adults, married, and uninsured young adults, as these individuals experienced the largest increases in risk prevalence over time putting them at high-risk for CVD.

Table of Contents

I. Introduction ...........................1

II. Methods ................................2

III. Results .................................6

IV. Discussion ............................9

V. References ............................15

VI. Tables and Figures ...............17

VII. Supplement ........................29

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palavra-chave	trends risk prevalence NHANES cardiometabolic young adults
Committee Chair / Thesis Advisor	Ali, Mohammed K, Emory University
Committee Members	Siegel, Karen Rae, Emory University
Partnering Agencies	CDC

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