title: Impact of BMI on the incidence of metabolic abnormalities in metabolically healthy men.
abstract: OBJECTIVE
  Although the existence of metabolically healthy obese (MHO) individuals has been recognized, little is known regarding metabolic health status in these subjects over time. Thus, we evaluated longitudinal changes in metabolic parameters among MHO subjects compared with metabolically healthy, normal-weight (MHNW) subjects.
  
  
  METHODS
  A cohort study was performed on 2599 Korean men, 30-59 years of age, with no evidence of fatty liver disease on ultrasound and no traits of metabolic syndrome at baseline. BMI was categorized based on criteria for Asian population. Study participants were followed annually or biennially between 2002 and 2009. At each visit, the fatty liver on ultrasound was assessed and metabolic abnormalities were measured. Parametric Cox models and a pooled logistic regression models were used to evaluate the relationships of BMI with incident metabolic abnormalities.
  
  
  RESULTS
  During 9647.1 person-years of follow-up, 1673 participants developed metabolic abnormalities. After adjusting for age, smoking, alcohol intake and exercise, higher baseline BMI categories predicted increased incidences of metabolic abnormalities in a dose-response manner. The hazard ratios (95% confidence intervals) for hypertriglyceridemia, prediabetes, pre-hypertension, low high-density lipoprotein-cholesterol, fatty liver, elevated high sensitivity-C reactive protein, elevated homeostasis model assessment of insulin resistance, any metabolic abnormality and metabolic syndrome among the MHO subjects compared with the MHNW subjects were 1.51 (1.23-1.85), 1.43 (1.19-1.72), 1.79 (1.45-2.22), 1.80 (1.30-2.49), 2.69 (2.19-3.31), 1.39 (1.16-1.67), 2.90 (2.31-3.62), 1.68 (1.45-1.93) and 1.84(1.02-3.30), respectively.
  
  
  CONCLUSIONS
  In this study, MHO individuals showed higher incidences of metabolic abnormalities compared with MHNW individuals. This suggests that initially MHO individuals undergo adverse metabolic changes associated with obesity over time.
authors.affiliation: Health Screening Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea.
authors.forename: Y
authors.initials: Y
authors.lastname: Chang
authors.forename: S
authors.initials: S
authors.lastname: Ryu
authors.forename: B S
authors.initials: BS
authors.lastname: Suh
authors.forename: K E
authors.initials: KE
authors.lastname: Yun
authors.forename: C W
authors.initials: CW
authors.lastname: Kim
authors.forename: S I
authors.initials: SI
authors.lastname: Cho
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D002097:C-Reactive Protein / Q000378:metabolism; D004032:Diet; D015444:Exercise; D005234:Fatty Liver / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015228:Hypertriglyceridemia / Q000453:epidemiology*; D015994:Incidence; D007333:Insulin Resistance; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D013997:Time Factors
chemical_list: D002097:C-Reactive Protein