Endocrinol Metab.  2011 Jun;26(2):133-141. 10.3803/EnM.2011.26.2.133.

Prevalence and Characteristics of Metabolically Obese but Normal Weight and Metabolically Healthy but Obese in Middle-aged Koreans: the Chungju Metabolic Disease Cohort (CMC) Study

• Lee SH
• Ha HS
• Park YJ
• Lee JH
• Yim HW
• Yoon KH
• Kang MI
• Lee WC
• Son HY
• Park YM
• Kwon HS

• KMID: 1497720
• DOI: http://doi.org/10.3803/EnM.2011.26.2.133

Abstract

BACKGROUND
We attempted to determine the prevalence and characteristics of metabolically obese but normal weight (MONW) and metabolically healthy but obese (MHO) individuals in a large cohort of middle-aged Koreans.
METHODS
8,987 non-diabetic subjects were selected from the Chungju Metabolic disease Cohort Study performed in 2003-2006. MONW was defined as a body mass index (BMI) > or = 18.5 and < 23 kg/m2 with a homeostasis model assessment of insulin resistance (HOMA-IR) in the highest quartile. MHO was defined as BMI > or = 25 kg/m2 with HOMA-IR in the lowest quartile.
RESULTS
The mean age of the subjects was 62.3 +/- 10.5 years (men 40.4%). The age-adjusted prevalence of MONW and MHO were 4.3% (5.3% men, 3.7% women) and 5.6% (3.6% men, 7.0% women), respectively. 14.2% of men and 12.9% of women were classified as MONW among the normal weight population, whereas 10.7% of men and 14.5% of women were classified as MHO among the obese subjects. The prevalence of prediabetes was significantly higher in the MONW group than in the MHO group (34.7 vs. 12.5%, P < 0.0001 in men; 23.1 vs. 8.8%, P < 0.0001 in women). The MONW group evidenced an equivalent risk of coronary heart disease (CHD) relative to the MHO group (10.77 +/- 0.68 vs. 10.22 +/- 0.90% in men; 7.02 +/- 0.34 vs. 7.26 +/- 0.26% in women, means +/- standard error [SE]).
CONCLUSION
The subjects in the MONW group are characterized by a high risk of diabetes and CHD, despite their normal weights. Their substantial prevalence in the population emphasizes the importance of identifying subjects in the MONW group, and warrants more intensive risk management.

Keyword

Cohort study; Insulin resistance; Metabolically healthy but obese; Metabolically obese but normal weight; Nondiabetic population

MeSH Terms

Body Mass Index
Cohort Studies
Coronary Disease
Female
Homeostasis
Humans
Insulin Resistance
Male
Metabolic Diseases
Prediabetic State
Prevalence
Risk Management
Weights and Measures

Figure

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  Fig. 1 Prevalence of MONW and MHO according to age groups. A. Men, B. Women. The numbers in the bars represent numbers of the subjects in each group. MHO, metabolically healthy but obese; MONW, metabolically obese but normal weight.

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  Fig. 2 Prevalence of metabolic diseases in MHNW, MONW, MHO, and MOO. A. Prediabetes in men, B. Hypertension in men, C. MetS in men, D. Prediabetes in women, E. Hypertension in women, F. MetS in women. *P < 0.05 versus MHNW; †P < 0.05 versus MONW; ‡P < 0.05 versus MHO. MHNW, metabolically healthy and normal weight; MHO, metabolically healthy but obese; MONW, metabolically obese but normal weight, MOO, metabolically obese and obese.

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  Fig. 3 Estimated age-adjusted 10-year CHD risk in MHNW, MONW, MHO, and MOO. A. Men, B. Women. Data are expressed as means ± SE. *P < 0.05 versus MHNW; †P < 0.05 versus MONW; ‡P < 0.05 versus MHO. MHNW, metabolically healthy and normal weight; MHO, metabolically healthy but obese; MONW, metabolically obese but normal weight, MOO, metabolically obese and obese.

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