{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T13:51:10Z","timestamp":1793195470270,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,2,22]],"date-time":"2021-02-22T00:00:00Z","timestamp":1613952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Few studies have evaluated the association between being underweight and having cardiovascular disease in the general population. We investigated the incidence of stroke, myocardial infarction (MI), and all\u2010cause mortality according to detailed underweight categories in a large population cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included 4\u00a0164\u00a0364 individuals who underwent a health examination that was conducted as part of the Korean National Health Insurance Service between January 2009 and December 2012 and followed them up to determine the incidence of stroke, MI, and all\u2010cause mortality until 31 December 2016. Based on the body mass index, the study population was categorized into normal (18.50\u201322.99), mild (17.00\u201318.49), moderate (16.00\u201316.99), and severe underweight (&lt;16.00) groups. Cox proportional hazards analyses were performed to calculate the hazard ratio for stroke, MI, and mortality according to the severity of underweight in reference to the normal weight. We adjusted for age, sex, lifestyle, economic status, co\u2010morbidity, blood pressure, glucose, lipid level, and waist circumference.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of the 4\u00a0164\u00a0364 eligible subjects in this study cohort was 44.4\u00a0\u00b1\u00a014.3\u00a0years, and 46.1% of the participants were male; 46\u00a0728 strokes, 30\u00a0074 MIs, and 121\u00a0080 deaths occurred during 27\u00a0449\u00a0902 person\u2010years. The incidence of stroke, MI, and all\u2010cause mortality increased proportionally with the severity of underweight in the multivariate model. This proportional association became more evident when the waist circumference was additionally adjusted. The respective hazard ratios (95% confidence intervals) for mild, moderate, and severe underweight were 1.10 (1.06\u20131.15), 1.11 (1.02\u20131.20), and 1.38 (1.24\u20131.53) for stroke; 1.19 (1.14\u20131.25), 1.40 (1.27\u20131.53), and 1.86 (1.64\u20132.11) for MI; and 1.63 (1.60\u20131.67), 2.10 (2.02\u20132.17), and 2.98 (2.85\u20133.11) for all\u2010cause mortality. In stratified analyses based on waist circumference, the severity of underweight was consistently associated with a higher risk of stroke, MI, and death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The severity of underweight was associated with a higher risk of stroke, MI, and all\u2010cause mortality.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12682","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T04:54:00Z","timestamp":1614056040000},"page":"331-338","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":80,"title":["Incidence of cardiovascular disease and mortality in underweight individuals"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0312-3650","authenticated-orcid":false,"given":"Hyuktae","family":"Kwon","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Seoul National University Hospital 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Long","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Seoul National University Hospital Seoul National University College of Medicine  Jongno\u2010gu Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6096-1263","authenticated-orcid":false,"given":"Kyungdo","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Biostatistics The Catholic University of Korea  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3854-7012","authenticated-orcid":false,"given":"Hee\u2010Kyung","family":"Joh","sequence":"additional","affiliation":[{"name":"Department of Medicine Seoul National University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1262-100X","authenticated-orcid":false,"given":"Ki 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