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Original Articles
Obesity and Metabolic Syndrome
The Risk of Myocardial Infarction and Ischemic Stroke According to Waist Circumference in 21,749,261 Korean Adults: A Nationwide Population-Based Study
Jung-Hwan Cho, Eun-Jung Rhee, Se-Eun Park, Hyemi Kwon, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Hye Soon Park, Yang-Hyun Kim, Soon-Jib Yoo, Won-Young Lee
Diabetes Metab J. 2019;43(2):206-221.   Published online December 27, 2018
DOI: https://doi.org/10.4093/dmj.2018.0039
  • 5,632 View
  • 102 Download
  • 22 Web of Science
  • 23 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Waist circumference (WC) is a well-known obesity index that predicts cardiovascular disease (CVD). We studied the relationship between baseline WC and development of incident myocardial infarction (MI) and ischemic stroke (IS) using a nationwide population-based cohort, and evaluated if its predictability is better than body mass index (BMI).

Methods

Our study included 21,749,261 Koreans over 20 years of age who underwent the Korean National Health Screening between 2009 and 2012. The occurrence of MI or IS was investigated until the end of 2015 using National Health Insurance Service data.

Results

A total of 127,289 and 181,637 subjects were newly diagnosed with MI and IS. The incidence rate and hazard ratio of MI and IS increased linearly as the WC level increased, regardless of adjustment for BMI. When the analyses were performed according to 11 groups of WC, the lowest risk of MI was found in subjects with WC of 70 to 74.9 and 65 to 69.9 cm in male and female, and the lowest risk of IS in subjects with WC of 65 to 69.9 and 60 to 64.9 cm in male and female, respectively. WC showed a better ability to predict CVD than BMI with smaller Akaike information criterion. The optimal WC cutoffs were 84/78 cm for male/female for predicting MI, and 85/78 cm for male/female for predicting IS.

Conclusion

WC had a significant linear relationship with the risk of MI and IS and the risk began to increase from a WC that was lower than expected.

Citations

Citations to this article as recorded by  
  • Usefulness of New Criteria for Metabolic Syndrome Optimized for Prediction of Cardiovascular Diseases in Japanese
    Yurie Yamazaki, Kazuya Fujihara, Takaaki Sato, Mayuko Harada Yamada, Yuta Yaguchi, Yasuhiro Matsubayashi, Takaho Yamada, Satoru Kodama, Kiminori Kato, Hitoshi Shimano, Hirohito Sone
    Journal of Atherosclerosis and Thrombosis.2024; 31(4): 382.     CrossRef
  • Association between body composition and subsequent cardiovascular diseases among 5-year breast cancer survivors
    Ji Soo Kim, Jihun Song, Seulggie Choi, Sung Min Kim, Young Jun Park, Sun Jae Park, Yoosun Cho, Yun Hwan Oh, Seogsong Jeong, Kyae Hyung Kim, Sang Min Park
    Nutrition, Metabolism and Cardiovascular Diseases.2024;[Epub]     CrossRef
  • Body mass index, waist circumference and cardiovascular diseases in transitional ages (40 and 66 years)
    Jung Eun Yoo, Kyungdo Han, Jin‐Hyung Jung, Yang‐Im Hur, Yang Hyun Kim, Eun Sook Kim, Jang Won Son, Eun‐Jung Rhee, Won‐Young Lee, Ga Eun Nam
    Journal of Cachexia, Sarcopenia and Muscle.2023; 14(1): 369.     CrossRef
  • Risk factors for stroke among anthropometric indices and lipid profiles in the Korean population: a large-scale cross-sectional study
    Mi Hong Yim, Young Ju Jeon, Bum Ju Lee
    Scientific Reports.2023;[Epub]     CrossRef
  • Big Data Research in the Field of Endocrine Diseases Using the Korean National Health Information Database
    Sun Wook Cho, Jung Hee Kim, Han Seok Choi, Hwa Young Ahn, Mee Kyoung Kim, Eun Jung Rhee
    Endocrinology and Metabolism.2023; 38(1): 10.     CrossRef
  • Research on obesity using the National Health Information Database: recent trends
    Eun-Jung Rhee
    Cardiovascular Prevention and Pharmacotherapy.2023; 5(2): 35.     CrossRef
  • Association between the weight-adjusted waist index and stroke: a cross-sectional study
    Jiayi Ye, Yanjie Hu, Xinrong Chen, Zhe Yin, Xingzhu Yuan, Liping Huang, Ka Li
    BMC Public Health.2023;[Epub]     CrossRef
  • Increased risk of ischemic stroke associated with elevated gamma-glutamyl transferase level in adult cancer survivors: a population-based cohort study
    Kyuwoong Kim, Hyeyun Jung, Edvige Di Giovanna, Tae Joon Jun, Young-Hak Kim
    Scientific Reports.2023;[Epub]     CrossRef
  • Changes in body composition and subsequent cardiovascular disease risk among 5-year breast cancer survivors
    Ji Soo Kim, Jihun Song, Seulggie Choi, Sang Min Park
    Frontiers in Cardiovascular Medicine.2023;[Epub]     CrossRef
  • Association between Stroke and Abdominal Obesity in the Middle-Aged and Elderly Korean Population: KNHANES Data from 2011–2019
    Jong Yeon Kim, Sung Min Cho, Youngmin Yoo, Taesic Lee, Jong Koo Kim
    International Journal of Environmental Research and Public Health.2022; 19(10): 6140.     CrossRef
  • Prevalence of metabolic syndrome and related factors in a large sample of antipsychotic naïve patients with first-episode psychosis: Baseline results from the PAFIP cohort
    Nathalia Garrido-Torres, Miguel Ruiz-Veguilla, Luis Alameda, Manuel Canal-Rivero, María Juncal Ruiz, Marcos Gómez-Revuelta, Rosa Ayesa-Arriola, Ana Rubio-García, Benedicto Crespo-Facorro, Javier Vázquez-Bourgon
    Schizophrenia Research.2022; 246: 277.     CrossRef
  • Development and validation of risk prediction models for stroke and mortality among patients with type 2 diabetes in northern China
    X. Shao, H. Liu, F. Hou, Y. Bai, Z. Cui, Y. Lin, X. Jiang, P. Bai, Y. Wang, Y. Zhang, C. Lu, H. Liu, S. Zhou, P. Yu
    Journal of Endocrinological Investigation.2022; 46(2): 271.     CrossRef
  • Neck circumference for predicting the occurrence of future cardiovascular events: A 7.6-year longitudinal study
    Tingting Hu, Yun Shen, Weijie Cao, Yiting Xu, Yufei Wang, Xiaojing Ma, Yuqian Bao
    Nutrition, Metabolism and Cardiovascular Diseases.2022; 32(12): 2830.     CrossRef
  • A prospective study of waist circumference trajectories and incident cardiovascular disease in China: the Kailuan Cohort Study
    Liang Wang, Yujin Lee, Yuntao Wu, Xinyuan Zhang, Cheng Jin, Zhe Huang, Yixin Wang, Zhiyi Wang, Penny Kris-Etherton, Shouling Wu, Xiang Gao
    The American Journal of Clinical Nutrition.2021; 113(2): 338.     CrossRef
  • The Repeatedly Elevated Fatty Liver Index Is Associated With Increased Mortality: A Population-Based Cohort Study
    Chang-Hoon Lee, Kyung-Do Han, Da Hye Kim, Min-Sun Kwak
    Frontiers in Endocrinology.2021;[Epub]     CrossRef
  • Obesity Degree and Glycemic Status: Factors That Should Be Considered in Heart Failure
    Hye Soon Kim
    Diabetes & Metabolism Journal.2020; 44(4): 529.     CrossRef
  • Exposure-weighted scoring for metabolic syndrome and the risk of myocardial infarction and stroke: a nationwide population-based study
    Eun Young Lee, Kyungdo Han, Da Hye Kim, Yong-Moon Park, Hyuk-Sang Kwon, Kun-Ho Yoon, Mee Kyoung Kim, Seung-Hwan Lee
    Cardiovascular Diabetology.2020;[Epub]     CrossRef
  • Predicting the Development of Myocardial Infarction in Middle-Aged Adults with Type 2 Diabetes: A Risk Model Generated from a Nationwide Population-Based Cohort Study in Korea
    Seung-Hwan Lee, Kyungdo Han, Hun-Sung Kim, Jae-Hyoung Cho, Kun-Ho Yoon, Mee Kyoung Kim
    Endocrinology and Metabolism.2020; 35(3): 636.     CrossRef
  • Obesity Fact Sheet in Korea, 2018: Data Focusing on Waist Circumference and Obesity-Related Comorbidities
    Ga Eun Nam, Yang-Hyun Kim, Kyungdo Han, Jin-Hyung Jung, Yong Gyu Park, Kwan-Woo Lee, Eun-Jung Rhee, Jang Won Son, Seong-Su Lee, Hyuk-Sang Kwon, Won-Young Lee, Soon Jib Yoo
    Journal of Obesity & Metabolic Syndrome.2019; 28(4): 236.     CrossRef
  • Simply the Best: Anthropometric Indices for Predicting Cardiovascular Disease
    Jie-Eun Lee
    Diabetes & Metabolism Journal.2019; 43(2): 156.     CrossRef
  • Association and Interaction Analysis of Lipid Accumulation Product with Impaired Fasting Glucose Risk: A Cross-Sectional Survey
    Jian Song, Xue Chen, Yuhong Jiang, Jing Mi, Yuyuan Zhang, Yingying Zhao, Xuesen Wu, Huaiquan Gao
    Journal of Diabetes Research.2019; 2019: 1.     CrossRef
  • Letter: Association of Z-Score of the Log-Transformed A Body Shape Index with Cardiovascular Disease in People Who Are Obese but Metabolically Healthy: The Korea National Health and Nutrition Examination Survey 2007-2010 (J Obes Metab Syndr 2018;27:158-65
    Eun-Jung Rhee
    Journal of Obesity & Metabolic Syndrome.2019; 28(2): 139.     CrossRef
  • Response: The Differential Association between Muscle Strength and Diabetes Mellitus According to the Presence or Absence of Obesity (J Obes Metab Syndr 2019;28:46-52)
    Bo Kyung Koo
    Journal of Obesity & Metabolic Syndrome.2019; 28(4): 297.     CrossRef
Serum Adiponectin and Type 2 Diabetes: A 6-Year Follow-Up Cohort Study
Sun Ha Jee, Chul Woo Ahn, Jong Suk Park, Chang Gyu Park, Hyon-Suk Kim, Sang-Hak Lee, Sungha Park, Myoungsook Lee, Chang Beom Lee, Hye Soon Park, Heejin Kimm, Sung Hee Choi, Jidong Sung, Seungjoon Oh, Hyojee Joung, Sung Rae Kim, Ho-Joong Youn, Sun Mi Kim, Hong Soo Lee, Yejin Mok, Eunmi Choi, Young Duk Yun, Soo-Jin Baek, Jaeseong Jo, Kap Bum Huh
Diabetes Metab J. 2013;37(4):252-261.   Published online August 14, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.4.252
  • 5,140 View
  • 40 Download
  • 9 Crossref
AbstractAbstract PDFPubReader   
Background

Studies on factors which may predict the risk of diabetes are scarce. This prospective cohort study was conducted to determine the association between adiponectin and type 2 diabetes among Korean men and women.

Methods

A total of 42,845 participants who visited one of seven health examination centers located in Seoul and Gyeonggi province, Republic of Korea between 2004 and 2008 were included in this study. The incidence rates of diabetes were determined through December 2011. To evaluate the effects of adiponectin on type 2 diabetes, the Cox proportional hazard model was used.

Results

Of the 40,005 participants, 959 developed type 2 diabetes during a 6-year follow-up. After the adjustment for age, body mass index (BMI), and waist circumference, the risks for type 2 diabetes in participants with normoglycemia had a 1.70-fold (95% confidence interval [CI], 1.21 to 2.38) increase in men and a 1.83-fold (95% CI, 1.17 to 2.86) increase in women with the lowest tertile of adiponectin when compared to the highest tertile of adiponectin. For participants with impaired fasting glucose (IFG), the risk for type 2 diabetes had a 1.46-fold (95% CI, 1.17 to 1.83) increase in men and a 2.52-fold (95% CI, 1.57 to 4.06) increase in women with the lowest tertile of adiponectin. Except for female participants with normoglycemia, all the risks remained significant after the adjustment for fasting glucose and other confounding variables. Surprisingly, BMI and waist circumference were not predictors of type 2 diabetes in men or women with IFG after adjustment for fasting glucose and other confounders.

Conclusion

A strong association between adiponectin and diabetes was observed. The use of adiponectin as a predictor of type 2 diabetes is considered to be useful.

Citations

Citations to this article as recorded by  
  • Adiponectin and metabolic cardiovascular diseases: Therapeutic opportunities and challenges
    Xiaotian Lei, Sheng Qiu, Gangyi Yang, Qinan Wu
    Genes & Diseases.2023; 10(4): 1525.     CrossRef
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    Young-Sang Kim, Soo-Hyun Lee, Seung Geon Park, Bo Youn Won, Hyejin Chun, Doo-Yeoun Cho, Moon-Jong Kim, Ji Eun Lee, Ji-Hee Haam, Kunhee Han
    Metabolism.2020; 103: 154026.     CrossRef
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    Biochemical and Biophysical Research Communications.2016; 477(3): 350.     CrossRef
  • Adiponectin as a Protective Factor Against the Progression Toward Type 2 Diabetes Mellitus in Postmenopausal Women
    Hossein Darabi, Alireza Raeisi, Mohammad Reza Kalantarhormozi, Afshin Ostovar, Majid Assadi, Kamyar Asadipooya, Katayoun Vahdat, Sina Dobaradaran, Iraj Nabipour
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    Journal of Diabetes and its Complications.2015; 29(3): 427.     CrossRef
  • Smoking and Diabetes: Is the Association Mediated by Adiponectin, Leptin, or C-reactive Protein?
    Esayas Haregot Hilawe, Hiroshi Yatsuya, Yuanying Li, Mayu Uemura, Chaochen Wang, Chifa Chiang, Hideaki Toyoshima, Koji Tamakoshi, Yan Zhang, Nobuo Kawazoe, Atsuko Aoyama
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    Anna Lubkowska, Aleksandra Dobek, Jan Mieszkowski, Wojciech Garczynski, Dariusz Chlubek
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Diabetes Metab J : Diabetes & Metabolism Journal