Higher mortality in metabolically obese normal-weight people than in metabolically healthy obese subjects in elderly Koreans

Kyung Mook Choi, Hyun Joo Cho, Hae Yoon Choi, Sae Jeong Yang, Hye-Jin Yoo, Ji A Seo, Sin Gon Kim, Sei-Hyun Baik, Dong Seop Choi, Nan Hee Kim

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Abstract

Objective The purpose of this study was to investigate the impact of body mass index (BMI) and the presence of metabolic syndrome (MetS) on all-cause and cardiovascular mortality in elderly Korean men and women, and especially to compare metabolically obese normal-weight (MONW) and metabolically healthy obese (MHO) subjects. Patients and methods A total of 2317 elderly people (over 60 years of age) were studied using follow-up data from the South-West Seoul (SWS) Study, a prospective cohort study. Mortality from all causes and cardiovascular disease (CVD) were evaluated according to the combination of the presence or absence of MetS and Asian-specific body mass index (BMI) criteria (BMI <23 kg/m2; normal weight, BMI 23-24·9 kg/m2; overweight, BMI ≥25 kg/m2; obesity). Results During a median follow-up of 10·3 years, 393 subjects died, including 126 from CVD. Among subjects with MetS, all-cause and CVD mortality were significantly higher in normal-weight subjects than overweight or obese individuals in Cox proportional-hazard models adjusted for confounding factors. Furthermore, among six groups with various MetS/BMI combinations, MONW individuals had the highest risk, whereas overweight subjects without MetS had the lowest risk of death from all causes and CVD [HR = 2·2 (95% CI = 1·4-3·4), HR = 3·0 (95% CI = 1·4-6·6) respectively]. Interestingly, all-cause mortality was significantly higher in MONW than MHO individuals. Conclusions In contrast to MHO subjects, elderly individuals with the MONW phenotype exhibited greater all-cause mortality during 10 years of follow-up.

Original languageEnglish
Pages (from-to)364-370
Number of pages7
JournalClinical Endocrinology
Volume79
Issue number3
DOIs
Publication statusPublished - 2013 Sep 1

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Healthy Volunteers
Body Mass Index
Weights and Measures
Mortality
Cardiovascular Diseases
Proportional Hazards Models
Cause of Death
Cohort Studies
Obesity
Prospective Studies
Phenotype

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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Higher mortality in metabolically obese normal-weight people than in metabolically healthy obese subjects in elderly Koreans. / Choi, Kyung Mook; Cho, Hyun Joo; Choi, Hae Yoon; Yang, Sae Jeong; Yoo, Hye-Jin; Seo, Ji A; Kim, Sin Gon; Baik, Sei-Hyun; Choi, Dong Seop; Kim, Nan Hee.

In: Clinical Endocrinology, Vol. 79, No. 3, 01.09.2013, p. 364-370.

Research output: Contribution to journalArticle

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abstract = "Objective The purpose of this study was to investigate the impact of body mass index (BMI) and the presence of metabolic syndrome (MetS) on all-cause and cardiovascular mortality in elderly Korean men and women, and especially to compare metabolically obese normal-weight (MONW) and metabolically healthy obese (MHO) subjects. Patients and methods A total of 2317 elderly people (over 60 years of age) were studied using follow-up data from the South-West Seoul (SWS) Study, a prospective cohort study. Mortality from all causes and cardiovascular disease (CVD) were evaluated according to the combination of the presence or absence of MetS and Asian-specific body mass index (BMI) criteria (BMI <23 kg/m2; normal weight, BMI 23-24·9 kg/m2; overweight, BMI ≥25 kg/m2; obesity). Results During a median follow-up of 10·3 years, 393 subjects died, including 126 from CVD. Among subjects with MetS, all-cause and CVD mortality were significantly higher in normal-weight subjects than overweight or obese individuals in Cox proportional-hazard models adjusted for confounding factors. Furthermore, among six groups with various MetS/BMI combinations, MONW individuals had the highest risk, whereas overweight subjects without MetS had the lowest risk of death from all causes and CVD [HR = 2·2 (95{\%} CI = 1·4-3·4), HR = 3·0 (95{\%} CI = 1·4-6·6) respectively]. Interestingly, all-cause mortality was significantly higher in MONW than MHO individuals. Conclusions In contrast to MHO subjects, elderly individuals with the MONW phenotype exhibited greater all-cause mortality during 10 years of follow-up.",
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AU - Choi, Kyung Mook

AU - Cho, Hyun Joo

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AU - Yang, Sae Jeong

AU - Yoo, Hye-Jin

AU - Seo, Ji A

AU - Kim, Sin Gon

AU - Baik, Sei-Hyun

AU - Choi, Dong Seop

AU - Kim, Nan Hee

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N2 - Objective The purpose of this study was to investigate the impact of body mass index (BMI) and the presence of metabolic syndrome (MetS) on all-cause and cardiovascular mortality in elderly Korean men and women, and especially to compare metabolically obese normal-weight (MONW) and metabolically healthy obese (MHO) subjects. Patients and methods A total of 2317 elderly people (over 60 years of age) were studied using follow-up data from the South-West Seoul (SWS) Study, a prospective cohort study. Mortality from all causes and cardiovascular disease (CVD) were evaluated according to the combination of the presence or absence of MetS and Asian-specific body mass index (BMI) criteria (BMI <23 kg/m2; normal weight, BMI 23-24·9 kg/m2; overweight, BMI ≥25 kg/m2; obesity). Results During a median follow-up of 10·3 years, 393 subjects died, including 126 from CVD. Among subjects with MetS, all-cause and CVD mortality were significantly higher in normal-weight subjects than overweight or obese individuals in Cox proportional-hazard models adjusted for confounding factors. Furthermore, among six groups with various MetS/BMI combinations, MONW individuals had the highest risk, whereas overweight subjects without MetS had the lowest risk of death from all causes and CVD [HR = 2·2 (95% CI = 1·4-3·4), HR = 3·0 (95% CI = 1·4-6·6) respectively]. Interestingly, all-cause mortality was significantly higher in MONW than MHO individuals. Conclusions In contrast to MHO subjects, elderly individuals with the MONW phenotype exhibited greater all-cause mortality during 10 years of follow-up.

AB - Objective The purpose of this study was to investigate the impact of body mass index (BMI) and the presence of metabolic syndrome (MetS) on all-cause and cardiovascular mortality in elderly Korean men and women, and especially to compare metabolically obese normal-weight (MONW) and metabolically healthy obese (MHO) subjects. Patients and methods A total of 2317 elderly people (over 60 years of age) were studied using follow-up data from the South-West Seoul (SWS) Study, a prospective cohort study. Mortality from all causes and cardiovascular disease (CVD) were evaluated according to the combination of the presence or absence of MetS and Asian-specific body mass index (BMI) criteria (BMI <23 kg/m2; normal weight, BMI 23-24·9 kg/m2; overweight, BMI ≥25 kg/m2; obesity). Results During a median follow-up of 10·3 years, 393 subjects died, including 126 from CVD. Among subjects with MetS, all-cause and CVD mortality were significantly higher in normal-weight subjects than overweight or obese individuals in Cox proportional-hazard models adjusted for confounding factors. Furthermore, among six groups with various MetS/BMI combinations, MONW individuals had the highest risk, whereas overweight subjects without MetS had the lowest risk of death from all causes and CVD [HR = 2·2 (95% CI = 1·4-3·4), HR = 3·0 (95% CI = 1·4-6·6) respectively]. Interestingly, all-cause mortality was significantly higher in MONW than MHO individuals. Conclusions In contrast to MHO subjects, elderly individuals with the MONW phenotype exhibited greater all-cause mortality during 10 years of follow-up.

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