title: Higher mortality in metabolically obese normal-weight people than in metabolically healthy obese subjects in elderly Koreans.
abstract: OBJECTIVE
  The purpose of this study was to investigate the impact of body mass index (BMI) and the presence of metabolic syndrome (MetS) on all-cause and cardiovascular mortality in elderly Korean men and women, and especially to compare metabolically obese normal-weight (MONW) and metabolically healthy obese (MHO) subjects.
  
  
  METHODS
  A total of 2317 elderly people (over 60 years of age) were studied using follow-up data from the South-West Seoul (SWS) Study, a prospective cohort study. Mortality from all causes and cardiovascular disease (CVD) were evaluated according to the combination of the presence or absence of MetS and Asian-specific body mass index (BMI) criteria (BMI <23 kg/m²; normal weight, BMI 23-24·9 kg/m²; overweight, BMI ≥25 kg/m²; obesity).
  
  
  RESULTS
  During a median follow-up of 10·3 years, 393 subjects died, including 126 from CVD. Among subjects with MetS, all-cause and CVD mortality were significantly higher in normal-weight subjects than overweight or obese individuals in Cox proportional-hazard models adjusted for confounding factors. Furthermore, among six groups with various MetS/BMI combinations, MONW individuals had the highest risk, whereas overweight subjects without MetS had the lowest risk of death from all causes and CVD [HR = 2·2 (95% CI = 1·4-3·4), HR = 3·0 (95% CI = 1·4-6·6) respectively]. Interestingly, all-cause mortality was significantly higher in MONW than MHO individuals.
  
  
  CONCLUSIONS
  In contrast to MHO subjects, elderly individuals with the MONW phenotype exhibited greater all-cause mortality during 10 years of follow-up.
authors: Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
authors: Kyung Mook
authors: KM
authors: Choi
authors: Hyun Joo
authors: HJ
authors: Cho
authors: Hae Yoon
authors: HY
authors: Choi
authors: Sae Jeong
authors: SJ
authors: Yang
authors: Hye Jin
authors: HJ
authors: Yoo
authors: Ji A
authors: JA
authors: Seo
authors: Sin Gon
authors: SG
authors: Kim
authors: Sei Hyun
authors: SH
authors: Baik
authors: Dong Seop
authors: DS
authors: Choi
authors: Nan Hee
authors: NH
authors: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000150:complications / Q000208:ethnology / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009765:Obesity / Q000208:ethnology / Q000401:mortality*; D010641:Phenotype; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D056910:Republic of Korea