1
|
Park JM, Lee HS, Yang J, Jung DH, Lee JW. Metabolic Obesity Phenotypes and Incident Cardiovascular Outcomes in Middle-Aged and Older Korean Adults: A Longitudinal 10-Year Analysis of the Korean Genome and Epidemiology Study. Metab Syndr Relat Disord 2024; 22:232-239. [PMID: 38603765 DOI: 10.1089/met.2023.0170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
Background: This study investigated the association of four metabolic obesity phenotypes with incident coronary artery disease and stroke in a large-scale, community population-based, prospective Korean cohort observed for over 10 years. Methods: The study participants included 7374 adults aged 40-69 years, drawn from the Korean Genome and Epidemiology Study. Participants with different metabolic obesity phenotypes were categorized according to body weight and metabolic health status into four groups: metabolically healthy nonobese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy nonobese (MUHNO), and metabolically unhealthy obese (MUHO). Combined cardiovascular events were defined as coronary artery disease and stroke. We used multivariate Cox proportional hazards regression models to prospectively assess hazard ratios (HRs) with 95% confidence intervals (CIs) for incident coronary artery disease or stroke over 10 years after the baseline survey. Results: During the follow-up period, newly developed coronary artery disease, stroke, and combined cardiovascular events were diagnosed in 151 (2.0%), 137 (1.9%), and 283 (3.8%) participants, respectively. After adjusting for confounding variables, the HRs (95% CIs) for incident combined cardiovascular events were 1.81 (1.34-2.46) in the MUHO group, 1.29 (0.92-1.81) in the MUHNO group, and 1.21 (0.81-1.79) in the MHO group compared with those in the MHNO group. Conclusions: This study revealed distinct risks associated with four metabolic obesity phenotypes concerning incident coronary artery disease and stroke. After adjusting for potential confounding variables, the results indicated that MUHO, but not MUHNO or MHO, showed a higher risk of developing coronary artery disease and stroke than MHNO.
Collapse
Affiliation(s)
- Jae-Min Park
- Department of Family Medicine, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Korea
- Department of Medicine, Graduate School of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Juyeon Yang
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong-Hyuk Jung
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Ji-Won Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea
| |
Collapse
|
2
|
Keenan K, Hipwell AE, Polonsky TS. Menstrual Cycle Irregularity in Adolescence Is Associated With Cardiometabolic Health in Early Adulthood. J Am Heart Assoc 2023; 12:e029372. [PMID: 37681544 PMCID: PMC10547276 DOI: 10.1161/jaha.123.029372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 07/18/2023] [Indexed: 09/09/2023]
Abstract
Background Menstrual cycle irregularities are associated with cardiovascular and cardiometabolic disease. We tested associations between age at menarche and cycle irregularity in adolescence and cardiometabolic health in early adulthood in a subsample from the Pittsburgh Girls Study. Methods and Results Data from annual interviews were used to assess age at menarche and cycle irregularity (ie, greater or less than every 27-29 days) at age 15 years. At ages 22 to 25 years, cardiometabolic health was measured in a subsample of the Pittsburgh Girls Study (n=352; 68.2% Black), including blood pressure, waist circumference, and fasting serum insulin, glucose, and lipids. T tests were used for continuous data and odds ratios for dichotomous data to compare differences in cardiometabolic health as a function of onset and regularity of menses. Early menarche (ie, before age 11 years; n=52) was associated with waist circumference (P=0.043). Participants reporting irregular cycles (n=50) in adolescence had significantly higher levels of insulin, glucose, and triglycerides, and higher systolic and diastolic blood pressure (P values range from 0.035 to 0.005) and were more likely to have clinical indicators of cardiometabolic predisease in early adulthood compared with women who reported regular cycles (odds ratios ranged from 1.89 to 2.56). Conclusions Increasing rates and earlier onset of cardiovascular and metabolic disease among women, especially among Black women, highlights the need for identifying early and reliable risk indices. Menstrual cycle irregularity may serve this purpose and help elucidate the role of women's reproductive health in protecting and conferring risk for later cardiovascular and cardiometabolic diseases.
Collapse
Affiliation(s)
- Kate Keenan
- Department of Psychiatry and Behavioral NeuroscienceUniversity of ChicagoILUSA
| | | | | |
Collapse
|
3
|
Park JM, Park DH, Song Y, Kim JO, Choi JE, Kwon YJ, Kim SJ, Lee JW, Hong KW. Understanding the genetic architecture of the metabolically unhealthy normal weight and metabolically healthy obese phenotypes in a Korean population. Sci Rep 2021; 11:2279. [PMID: 33500527 PMCID: PMC7838176 DOI: 10.1038/s41598-021-81940-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/14/2021] [Indexed: 01/30/2023] Open
Abstract
Understanding the mechanisms underlying the metabolically unhealthy normal weight (MUHNW) and metabolically healthy obese (MHO) phenotypes is important for developing strategies to prevent cardiometabolic diseases. Here, we conducted genome-wide association studies (GWASs) to identify the MUHNW and MHO genetic indices. The study dataset comprised genome-wide single-nucleotide polymorphism genotypes and epidemiological data from 49,915 subjects categorised into four phenotypes-metabolically healthy normal weight (MHNW), MUHNW, MHO, and metabolically unhealthy obese (MUHO). We conducted two GWASs using logistic regression analyses and adjustments for confounding variables (model 1: MHNW versus MUHNW and model 2: MHO versus MUHO). GCKR, ABCB11, CDKAL1, LPL, CDKN2B, NT5C2, APOA5, CETP, and APOC1 were associated with metabolically unhealthy phenotypes among normal weight individuals (model 1). LPL, APOA5, and CETP were associated with metabolically unhealthy phenotypes among obese individuals (model 2). The genes common to both models are related to lipid metabolism (LPL, APOA5, and CETP), and those associated with model 1 are related to insulin or glucose metabolism (GCKR, CDKAL1, and CDKN2B). This study reveals the genetic architecture of the MUHNW and MHO phenotypes in a Korean population-based cohort. These findings could help identify individuals at a high metabolic risk in normal weight and obese populations and provide potential novel targets for the management of metabolically unhealthy phenotypes.
Collapse
Affiliation(s)
- Jae-Min Park
- grid.15444.300000 0004 0470 5454Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju‐ro, Gangnam-gu, Seoul, 06273 Korea ,grid.15444.300000 0004 0470 5454Department of Medicine, Graduate School of Medicine, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Korea
| | - Da-Hyun Park
- Theragen Bio Co., Ltd., 145 Gwanggyo-ro, Suwon-si, Gyeonggi-do 16229 Korea
| | - Youhyun Song
- grid.15444.300000 0004 0470 5454Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju‐ro, Gangnam-gu, Seoul, 06273 Korea
| | - Jung Oh Kim
- Theragen Bio Co., Ltd., 145 Gwanggyo-ro, Suwon-si, Gyeonggi-do 16229 Korea
| | - Ja-Eun Choi
- Theragen Bio Co., Ltd., 145 Gwanggyo-ro, Suwon-si, Gyeonggi-do 16229 Korea
| | - Yu-Jin Kwon
- grid.15444.300000 0004 0470 5454Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si, Gyeonggi-do 16995 Korea
| | - Seong-Jin Kim
- Theragen Bio Co., Ltd., 145 Gwanggyo-ro, Suwon-si, Gyeonggi-do 16229 Korea
| | - Ji-Won Lee
- grid.15444.300000 0004 0470 5454Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju‐ro, Gangnam-gu, Seoul, 06273 Korea
| | - Kyung-Won Hong
- Theragen Bio Co., Ltd., 145 Gwanggyo-ro, Suwon-si, Gyeonggi-do 16229 Korea
| |
Collapse
|