Affiliation:
1. Department of Family Medicine Seoul National University Hospital Seoul Republic of Korea
2. Office of Hospital Information Seoul National University Hospital Seoul Republic of Korea
3. Department of Biomedical Sciences Seoul National University Graduate School Seoul Republic of Korea
4. Department of Family Medicine Seoul National University Bundang Hospital Seongnam Republic of Korea
5. Samsung C&T Medical Clinic Kangbuk Samsung Hospital Seoul Republic of Korea
6. Department of Family Medicine Samsung Medical Center Seoul Republic of Korea
Abstract
Background
The combined effect of transitions of metabolic health and weight on cardiovascular disease (
CVD
) remains unclear. We aimed to examine the association of concurrent changes of metabolic health and weight on
CVD
over time.
Methods and Results
The study population consisted of 205 394 from the Korean National Health Insurance Service. Metabolic health was determined by fasting serum glucose, total cholesterol, and blood pressure levels, while obesity was determined by body mass index. All participants were divided into either metabolically healthy nonobese (
MHNO
), metabolically healthy obese, metabolically unhealthy nonobese, or metabolically unhealthy obese for each of the first (2002–2003) and second (2004–2005) health screening periods, after which participants were followed‐up for
CVD
from 2006 to 2015. Cox proportional hazards regression was used to determine adjusted hazard ratios (
aHR
s) and 95%
CI
s. Among initial
MHNO
participants, those who became metabolically healthy obese (
aHR
, 1.25; 95%
CI
, 1.10–1.41), metabolically unhealthy nonobese (
aHR
, 1.23; 95%
CI
, 1.15–1.31), and metabolically unhealthy obese (
aHR
, 1.34; 95%
CI
, 1.12–1.61) had elevated risk for
CVD
compared with those who remained
MHNO
. Conversely, improving metabolic health and obesity were associated with reduced
CVD
risk among initially metabolically unhealthy nonobese to secondary
MHNO
(
aHR
, 0.79; 95%
CI
, 0.73–0.84), metabolically unhealthy obese to
MHNO
(
aHR
, 0.68; 95%
CI
, 0.58–0.81), and metabolically unhealthy obese to metabolically healthy obese (
aHR,
0.73; 95%
CI
, 0.66–0.80) participants.
Conclusions
Changes toward metabolically unhealthy or obese states resulted in increased
CVD
risk. Improving metabolic health along with reducing weight may lead to decreased risk of
CVD
.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
19 articles.
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