{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:54:59Z","timestamp":1787018099857,"version":"build-2736575974"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,9,3]]},"abstract":"\n Background<\/jats:title>\n \n The combined effect of transitions of metabolic health and weight on cardiovascular disease (\n CVD<\/jats:styled-content>\n ) remains unclear. We aimed to examine the association of concurrent changes of metabolic health and weight on\n CVD<\/jats:styled-content>\n over time.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n The study population consisted of 205\u00a0394 from the Korean National Health Insurance Service. Metabolic health was determined by fasting serum glucose, total cholesterol, and blood pressure levels, while obesity was determined by body mass index. All participants were divided into either metabolically healthy nonobese (\n MHNO<\/jats:styled-content>\n ), metabolically healthy obese, metabolically unhealthy nonobese, or metabolically unhealthy obese for each of the first (2002\u20132003) and second (2004\u20132005) health screening periods, after which participants were followed\u2010up for\n CVD<\/jats:styled-content>\n from 2006 to 2015. Cox proportional hazards regression was used to determine adjusted hazard ratios (\n aHR<\/jats:styled-content>\n s) and 95%\n CI<\/jats:styled-content>\n s. Among initial\n MHNO<\/jats:styled-content>\n participants, those who became metabolically healthy obese (\n aHR<\/jats:styled-content>\n , 1.25; 95%\n CI<\/jats:styled-content>\n , 1.10\u20131.41), metabolically unhealthy nonobese (\n aHR<\/jats:styled-content>\n , 1.23; 95%\n CI<\/jats:styled-content>\n , 1.15\u20131.31), and metabolically unhealthy obese (\n aHR<\/jats:styled-content>\n , 1.34; 95%\n CI<\/jats:styled-content>\n , 1.12\u20131.61) had elevated risk for\n CVD<\/jats:styled-content>\n compared with those who remained\n MHNO<\/jats:styled-content>\n . Conversely, improving metabolic health and obesity were associated with reduced\n CVD<\/jats:styled-content>\n risk among initially metabolically unhealthy nonobese to secondary\n MHNO<\/jats:styled-content>\n (\n aHR<\/jats:styled-content>\n , 0.79; 95%\n CI<\/jats:styled-content>\n , 0.73\u20130.84), metabolically unhealthy obese to\n MHNO<\/jats:styled-content>\n (\n aHR<\/jats:styled-content>\n , 0.68; 95%\n CI<\/jats:styled-content>\n , 0.58\u20130.81), and metabolically unhealthy obese to metabolically healthy obese (\n aHR,<\/jats:styled-content>\n 0.73; 95%\n CI<\/jats:styled-content>\n , 0.66\u20130.80) participants.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Changes toward metabolically unhealthy or obese states resulted in increased\n CVD<\/jats:styled-content>\n risk. Improving metabolic health along with reducing weight may lead to decreased risk of\n CVD<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.118.011825","type":"journal-article","created":{"date-parts":[[2019,8,27]],"date-time":"2019-08-27T05:02:14Z","timestamp":1566882134000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Association of Concurrent Changes in Metabolic Health and Weight on Cardiovascular Disease Risk: A Nationally Representative Cohort Study"],"prefix":"10.1161","volume":"8","author":[{"given":"Ye Seul","family":"Bae","sequence":"first","affiliation":[{"name":"Department of Family Medicine Seoul National University Hospital Seoul Republic of Korea"},{"name":"Office of Hospital Information Seoul National University Hospital Seoul Republic of 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