Association of Concurrent Changes in Metabolic Health and Weight on Cardiovascular Disease Risk: A Nationally Representative Cohort Study
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...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-09-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.118.011825 |
| _version_ | 1818288098125021184 |
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| author | Ye Seul Bae Seulggie Choi Kiheon Lee Joung Sik Son Hyejin Lee Mi Hee Cho Hye‐Yeon Koo In Young Cho Jooyoung Chang Kyuwoong Kim Sung Min Kim Sang Min Park |
| author_facet | Ye Seul Bae Seulggie Choi Kiheon Lee Joung Sik Son Hyejin Lee Mi Hee Cho Hye‐Yeon Koo In Young Cho Jooyoung Chang Kyuwoong Kim Sung Min Kim Sang Min Park |
| author_sort | Ye Seul Bae |
| collection | DOAJ |
| description | 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 (aHRs) and 95% CIs. 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. |
| first_indexed | 2024-12-13T01:50:58Z |
| format | Article |
| id | doaj.art-8435069347304485a3f3835b1c3a60cb |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T01:50:58Z |
| publishDate | 2019-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-8435069347304485a3f3835b1c3a60cb2022-12-22T00:03:31ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802019-09-0181710.1161/JAHA.118.011825Association of Concurrent Changes in Metabolic Health and Weight on Cardiovascular Disease Risk: A Nationally Representative Cohort StudyYe Seul Bae0Seulggie Choi1Kiheon Lee2Joung Sik Son3Hyejin Lee4Mi Hee Cho5Hye‐Yeon Koo6In Young Cho7Jooyoung Chang8Kyuwoong Kim9Sung Min Kim10Sang Min Park11Department of Family Medicine Seoul National University Hospital Seoul Republic of KoreaDepartment of Biomedical Sciences Seoul National University Graduate School Seoul Republic of KoreaDepartment of Family Medicine Seoul National University Bundang Hospital Seongnam Republic of KoreaDepartment of Family Medicine Seoul National University Hospital Seoul Republic of KoreaDepartment of Family Medicine Seoul National University Bundang Hospital Seongnam Republic of KoreaSamsung C&T Medical Clinic Kangbuk Samsung Hospital Seoul Republic of KoreaDepartment of Family Medicine Seoul National University Bundang Hospital Seongnam Republic of KoreaDepartment of Family Medicine Samsung Medical Center Seoul Republic of KoreaDepartment of Biomedical Sciences Seoul National University Graduate School Seoul Republic of KoreaDepartment of Biomedical Sciences Seoul National University Graduate School Seoul Republic of KoreaDepartment of Biomedical Sciences Seoul National University Graduate School Seoul Republic of KoreaDepartment of Family Medicine Seoul National University Hospital Seoul Republic of KoreaBackground 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 (aHRs) and 95% CIs. 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.https://www.ahajournals.org/doi/10.1161/JAHA.118.011825cardiovascular diseasehigh blood pressurehypercholesterolemiahyperglycemiahypertensionobesity |
| spellingShingle | Ye Seul Bae Seulggie Choi Kiheon Lee Joung Sik Son Hyejin Lee Mi Hee Cho Hye‐Yeon Koo In Young Cho Jooyoung Chang Kyuwoong Kim Sung Min Kim Sang Min Park Association of Concurrent Changes in Metabolic Health and Weight on Cardiovascular Disease Risk: A Nationally Representative Cohort Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiovascular disease high blood pressure hypercholesterolemia hyperglycemia hypertension obesity |
| title | Association of Concurrent Changes in Metabolic Health and Weight on Cardiovascular Disease Risk: A Nationally Representative Cohort Study |
| title_full | Association of Concurrent Changes in Metabolic Health and Weight on Cardiovascular Disease Risk: A Nationally Representative Cohort Study |
| title_fullStr | Association of Concurrent Changes in Metabolic Health and Weight on Cardiovascular Disease Risk: A Nationally Representative Cohort Study |
| title_full_unstemmed | Association of Concurrent Changes in Metabolic Health and Weight on Cardiovascular Disease Risk: A Nationally Representative Cohort Study |
| title_short | Association of Concurrent Changes in Metabolic Health and Weight on Cardiovascular Disease Risk: A Nationally Representative Cohort Study |
| title_sort | association of concurrent changes in metabolic health and weight on cardiovascular disease risk a nationally representative cohort study |
| topic | cardiovascular disease high blood pressure hypercholesterolemia hyperglycemia hypertension obesity |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.118.011825 |
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