{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T11:03:03Z","timestamp":1775646183818,"version":"3.50.1"},"reference-count":30,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T00:00:00Z","timestamp":1649721600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Taipei Veterans General Hospital, Taipei, Taiwan","award":["V96S3\u2013001"],"award-info":[{"award-number":["V96S3\u2013001"]}]},{"name":"Taipei Veterans General Hospital, Taipei, Taiwan","award":["V96S3\u2013002"],"award-info":[{"award-number":["V96S3\u2013002"]}]},{"name":"Taipei Veterans General Hospital, Taipei, Taiwan","award":["V96S3\u2013005"],"award-info":[{"award-number":["V96S3\u2013005"]}]},{"name":"Taipei Veterans General Hospital, Taipei, Taiwan","award":["V97S3 \u2013001"],"award-info":[{"award-number":["V97S3 \u2013001"]}]},{"name":"Taipei Veterans General Hospital, Taipei, Taiwan","award":["V97S3 \u2013002"],"award-info":[{"award-number":["V97S3 \u2013002"]}]},{"name":"Taipei Veterans General Hospital, Taipei, Taiwan","award":["V97S3 \u2013005"],"award-info":[{"award-number":["V97S3 \u2013005"]}]},{"name":"Taipei Veterans General Hospital, Taipei, Taiwan","award":["V98S3 \u2013001"],"award-info":[{"award-number":["V98S3 \u2013001"]}]},{"name":"Taipei Veterans General Hospital, Taipei, Taiwan","award":["V98S3 \u2013002"],"award-info":[{"award-number":["V98S3 \u2013002"]}]},{"name":"Taipei Veterans General Hospital, Taipei, Taiwan","award":["V98S3 \u2013005"],"award-info":[{"award-number":["V98S3 \u2013005"]}]},{"name":"Taipei Veterans General Hospital, Taipei, Taiwan","award":["V99S3 \u2013001"],"award-info":[{"award-number":["V99S3 \u2013001"]}]},{"name":"Taipei Veterans General Hospital, Taipei, Taiwan","award":["V99S3 \u2013002"],"award-info":[{"award-number":["V99S3 \u2013002"]}]},{"name":"Taipei Veterans General Hospital, Taipei, Taiwan","award":["V99S3 \u2013005"],"award-info":[{"award-number":["V99S3 \u2013005"]}]},{"name":"Taipei Veterans General Hospital, Taipei, Taiwan","award":["V106E-005-1"],"award-info":[{"award-number":["V106E-005-1"]}]},{"name":"Taipei Veterans General Hospital, Taipei, Taiwan","award":["V106E-005-2"],"award-info":[{"award-number":["V106E-005-2"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>For people who are overweight or obese, maintaining a metabolically healthy status can decrease the risks of developing cardiovascular diseases and Type 2 diabetes. Despite this, only a limited amount of research has discussed the metabolically healthy overweight and obesity (MHOO) population in Asia and the factors associated with them maintaining their metabolic health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study enrolled 195 MHOO participants from communities in northern Taiwan during 2009\u20132010 (baseline). Of the 195 participants, 89 completed the follow-up assessment after a median follow-up time of nine years. Body type was determined by body mass index (BMI, kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). We defined overweight as a BMI\u00a0\u2265 24 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and &lt;27 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and defined obese as a BMI \u2265 27 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . Metabolic health was defined as the absence of cardiometabolic diseases and the presence of \u22641 of the cardiometabolic risk factors, namely hypertension, hyperglycemia, hypertriglyceridemia, and low serum high-density lipoprotein cholesterol. Metabolic health, BMI, and other covariates were evaluated at both baseline and follow-up. Generalized estimating equations (GEE) models were used to analyze the factors associated with maintenance of metabolic health during the follow-up period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, the mean age of the study participants was 47.4 (SD 5.3) years and 46 (51.7%) of the participants were women. There were 51 (57.3%) individuals who maintained their metabolic health status at the time of the nine-year follow-up. The detrimental factors pertaining to metabolic health included older age, longer duration until follow-up, BMI\u00a0\u2265 27\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , and increase in waist circumference. No significant relationships were observed between sociodemographic factors and lifestyle factors, such as sex, level of education, cigarette smoking, alcohol consumption, and physical activity, and sustained metabolic health among MHOO individuals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>To maintain metabolic health and prevent negative changes in health status, control of bodyweight and waist circumference should remain a priority for MHOO individuals even when there are no metabolic disorders present.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.13242","type":"journal-article","created":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T03:50:15Z","timestamp":1649735415000},"page":"e13242","source":"Crossref","is-referenced-by-count":2,"title":["Factors related to overweight and obese populations maintaining metabolic 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Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harn-Shen","family":"Chen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan"},{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu-Chiung","family":"Chiang","sequence":"additional","affiliation":[{"name":"Institute of Hospital and Health Care Administration, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tzeng-Ji","family":"Chen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan"},{"name":"Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan"},{"name":"Institute of Hospital and Health Care Administration, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinn-Jang","family":"Hwang","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan"},{"name":"Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4443","published-online":{"date-parts":[[2022,4,12]]},"reference":[{"issue":"2","key":"10.7717\/peerj.13242\/ref-1","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1038\/ijo.2014.113","article-title":"Predicting the development of the metabolically healthy obese phenotype","volume":"39","author":"Achilike","year":"2015","journal-title":"International Journal of 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