{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:41:26Z","timestamp":1765888886978,"version":"3.40.5"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T00:00:00Z","timestamp":1651017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Obesity is associated with cardiovascular diseases and is a risk factor for all-cause mortality. Until now, the associations between abdominal obesity and mortality or cardiovascular disease (CVD) incidence have not been conclusive. We aimed to evaluate the associations between waist circumference (WC) and mortality or CVD incidence in a general Korean population.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We analyzed a total of 204,068 adults older than 40 years of age who had undergone a national health examination at least once from 2009 to 2018 in the Korean National Health Insurance Service Cohort. WC was divided into five categories (&lt; 80, 80\u201384.9, 85\u201389.9, 90\u201394.9, \u2265 95 cm). Hazard ratios for death and CVD incidence were calculated using Cox proportional hazards models.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>In men, WC and overall mortality showed a reverse J-shaped association. In women, the association between WC and overall mortality was not significant. For both men and women, WC was not associated with the risk of cardiovascular mortality. Contrary to the mortality trend, CVD incidence was positively associated with WC in both men and women, and the risk of the CVD incidence was the lowest in subjects with a WC &lt; 80 cm.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>WC exhibited a significant J-shaped association with overall mortality in men, where subjects who had central obesity showed a lower rate of mortality than those in the lowest or highest WC group. The risk of incident CVD showed a positive association with central obesity, where the lowest risk was observed for subjects in the lowest WC group in a general Korean population.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0267597","type":"journal-article","created":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T17:32:08Z","timestamp":1651080728000},"page":"e0267597","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":17,"title":["Waist circumference and mortality or cardiovascular events in a general Korean population"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2101-6661","authenticated-orcid":true,"given":"Do Kyeong","family":"Song","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Sun","family":"Hong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeon-Ah","family":"Sung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4446-6470","authenticated-orcid":true,"given":"Hyejin","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,4,27]]},"reference":[{"key":"pone.0267597.ref001","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1016\/S0140-6736(05)67483-1","volume":"366","author":"D Haslam","year":"2005","journal-title":"Obesity. Lancet"},{"key":"pone.0267597.ref002","doi-asserted-by":"crossref","first-page":"i2156","DOI":"10.1136\/bmj.i2156","article-title":"BMI and all cause mortality: systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants","volume":"353","author":"D Aune","year":"2016","journal-title":"BMJ"},{"issue":"10046","key":"pone.0267597.ref003","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1016\/S0140-6736(16)30175-1","article-title":"Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents","volume":"388","author":"E Di Angelantonio","year":"2016","journal-title":"Lancet"},{"issue":"8","key":"pone.0267597.ref004","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1056\/NEJMoa055643","article-title":"Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old","volume":"355","author":"KF Adams","year":"2006","journal-title":"N Engl J Med"},{"issue":"1","key":"pone.0267597.ref005","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1001\/jama.2012.113905","article-title":"Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis","volume":"309","author":"KM Flegal","year":"2013","journal-title":"JAMA"},{"issue":"12","key":"pone.0267597.ref006","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1016\/S2213-8587(18)30288-2","article-title":"Association of BMI with overall and cause-specific mortality: a population-based cohort study of 3\u00b7 6 million adults in the UK","volume":"6","author":"K Bhaskaran","year":"2018","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"8","key":"pone.0267597.ref007","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1056\/NEJMoa054017","article-title":"Body-mass index and mortality in Korean men and women","volume":"355","author":"SH Jee","year":"2006","journal-title":"N Engl J Med"},{"issue":"9","key":"pone.0267597.ref008","doi-asserted-by":"crossref","first-page":"e0185024","DOI":"10.1371\/journal.pone.0185024","article-title":"Associations between body mass index and mortality or cardiovascular events in a general Korean population","volume":"12","author":"KA Kong","year":"2017","journal-title":"PLoS One"},{"issue":"3","key":"pone.0267597.ref009","doi-asserted-by":"crossref","first-page":"S33","DOI":"10.1038\/sj.ejcn.1601023","article-title":"Body weight and weight change and their health implications for the elderly","volume":"54","author":"JC Seidell","year":"2000","journal-title":"Eur J Clin Nutr"},{"issue":"5","key":"pone.0267597.ref010","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1038\/oby.2007.632","article-title":"Waist circumference and cardiometabolic risk: a consensus statement from shaping America\u2019s health: Association for Weight Management and Obesity Prevention; NAASO, the Obesity Society; the American Society for Nutrition; and the American Diabetes Association","volume":"15","author":"S Klein","year":"2007","journal-title":"Obesity"},{"issue":"1","key":"pone.0267597.ref011","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1111\/dom.13050","article-title":"Body fat distribution is more predictive of all-cause mortality than overall adiposity","volume":"20","author":"SW Lee","year":"2018","journal-title":"Diabetes Obes Metab"},{"issue":"1","key":"pone.0267597.ref012","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1038\/ejcn.2009.71","article-title":"Waist circumference and waist\/hip ratio in relation to all-cause mortality, cancer and sleep apnea","volume":"64","author":"J. 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