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The Risk of Myocardial Infarction and Ischemic Stroke According to Waist Circumference in 21,749,261 Korean Adults: A Nationwide Population-Based Study.
Diabetes Metab J. 2019 04; 43(2):206-221.DM

Abstract

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.

Authors+Show Affiliations

Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Biostatistics, Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea.Department of Biostatistics, Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea.Department of Biostatistics, Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea.Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Family Medicine, Korea University College of Medicine, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea. sjyoo@catholic.ac.kr.Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. drlwy@hanmail.net.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30604597

Citation

Cho, Jung Hwan, et al. "The Risk of Myocardial Infarction and Ischemic Stroke According to Waist Circumference in 21,749,261 Korean Adults: a Nationwide Population-Based Study." Diabetes & Metabolism Journal, vol. 43, no. 2, 2019, pp. 206-221.
Cho JH, Rhee EJ, Park SE, et al. The Risk of Myocardial Infarction and Ischemic Stroke According to Waist Circumference in 21,749,261 Korean Adults: A Nationwide Population-Based Study. Diabetes Metab J. 2019;43(2):206-221.
Cho, J. H., Rhee, E. J., Park, S. E., Kwon, H., Jung, J. H., Han, K. D., Park, Y. G., Park, H. S., Kim, Y. H., Yoo, S. J., & Lee, W. Y. (2019). The Risk of Myocardial Infarction and Ischemic Stroke According to Waist Circumference in 21,749,261 Korean Adults: A Nationwide Population-Based Study. Diabetes & Metabolism Journal, 43(2), 206-221. https://doi.org/10.4093/dmj.2018.0039
Cho JH, et al. The Risk of Myocardial Infarction and Ischemic Stroke According to Waist Circumference in 21,749,261 Korean Adults: a Nationwide Population-Based Study. Diabetes Metab J. 2019;43(2):206-221. PubMed PMID: 30604597.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Risk of Myocardial Infarction and Ischemic Stroke According to Waist Circumference in 21,749,261 Korean Adults: A Nationwide Population-Based Study. AU - Cho,Jung Hwan, AU - Rhee,Eun Jung, AU - Park,Se Eun, AU - Kwon,Hyemi, AU - Jung,Jin Hyung, AU - Han,Kyung Do, AU - Park,Yong Gyu, AU - Park,Hye Soon, AU - Kim,Yang Hyun, AU - Yoo,Soon Jib, AU - Lee,Won Young, AU - ,, Y1 - 2018/11/21/ PY - 2018/02/25/received PY - 2018/09/03/accepted PY - 2019/1/4/pubmed PY - 2019/1/4/medline PY - 2019/1/4/entrez KW - Body mass index KW - Cardiovascular diseases KW - Cohort studies KW - National Health Programs KW - Observational study KW - Waist circumference SP - 206 EP - 221 JF - Diabetes & metabolism journal JO - Diabetes Metab J VL - 43 IS - 2 N2 - 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. SN - 2233-6079 UR - https://www.unboundmedicine.com/medline/citation/30604597/The_Risk_of_Myocardial_Infarction_and_Ischemic_Stroke_According_to_Waist_Circumference_in_21749261_Korean_Adults:_A_Nationwide_Population_Based_Study_ L2 - https://e-dmj.org/DOIx.php?id=10.4093/dmj.2018.0039 DB - PRIME DP - Unbound Medicine ER -