Obesity, metabolic health, and mortality in adults: a nationwide population-based study in Korea

• Published in: Scientific reports 2016-07, Vol.6 (1), p.30329-30329, Article 30329
• Main Authors: Yang, Hae Kyung, Han, Kyungdo, Kwon, Hyuk-Sang, Park, Yong-Moon, Cho, Jae-Hyoung, Yoon, Kun-Ho, Kang, Moo-Il, Cha, Bong-Yun, Lee, Seung-Hwan
• Format: Article
• Language: English
• Subjects: 692/163/2743/393; 692/308/174; 692/308/409; 692/699/2743/393; Adult; Aged; Body Mass Index; Databases, Factual; Diabetes Mellitus - mortality; Diabetes Mellitus - physiopathology; Dyslipidemias - mortality; Dyslipidemias - physiopathology; Female; Follow-Up Studies; Humanities and Social Sciences; Humans; Hypertension - mortality; Hypertension - physiopathology; Male; Metabolic Diseases - mortality; Metabolic Diseases - physiopathology; Middle Aged; multidisciplinary; Obesity - mortality; Obesity - physiopathology; Phenotype; Republic of Korea; Risk Factors; Science; Science (multidisciplinary); Young Adult
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/srep30329

BMI, metabolic health status, and their interactions should be considered for estimating mortality risk; however, the data are controversial and unknown in Asians. We aimed to investigate this issue in Korean population. Total 323175 adults were followed-up for 96 (60–120) (median [5–95%]) months in a nationwide population-based cohort study. Participants were classified as “obese” (O) or “non-obese” (NO) using a BMI cut-off of 25 kg/m 2 . People who developed ≥1 metabolic disease component (hypertension, diabetes, dyslipidaemia) in the index year were considered “metabolically unhealthy” (MU), while those with none were considered “metabolically healthy” (MH). The MUNO group had a significantly higher risk of all-cause (hazard ratio, 1.28 [95% CI, 1.21–1.35]) and cardiovascular (1.88 [1.63–2.16]) mortality, whereas the MHO group had a lower mortality risk (all-cause: 0.81 [0.74–0.88]), cardiovascular: 0.73 [0.57–0.95]), compared to the MHNO group. A similar pattern was noted for cancer and other-cause mortality. Metabolically unhealthy status was associated with higher risk of all-cause and cardiovascular mortality regardless of BMI levels, and there was a dose-response relationship between the number of incident metabolic diseases and mortality risk. In conclusion, poor metabolic health status contributed more to mortality than high BMI did, in Korean adults.