Prevalence of combined metabolic health and weight status by various diagnosis criteria and association with cardiometabolic disease in Korean adults

The purpose of this study was to compare the cardiometabolic disease prevalence and risk factors between individuals categorized as metabolically unhealthy and healthy (MU vs. MH), with normal-weight and obesity (Nw vs. Ob), according to different established criteria for combined metabolic health and weight status; and to assess the optimal metabolic health diagnostic classifications to predict cardiometabolic disease risk factors. Data were obtained from the 2019 and 2020 Korean National Health and Nutrition Examination Surveys. We applied the nine accepted metabolic health diagnostic classification criteria. Statistical analysis was applied to frequency, multiple logistic regression, and ROC curve analysis. The prevalence of MHNw ranged from 24.6% to 53.9%, MUNw from 3.7% to 37.9%, MHOb from 3.4% to 25.9%, and MUOb from 16.3% to 39.1%. For hypertension, the MUNw had an increased risk ranging from 1.90 to 3.24 times compared with MHNw; MHOb ranged from 1.84 to 3.76 times; MUOb ranged from 4.18 to 6.97 times (all p < .05). For dyslipidemia, the MUNw had an increased risk ranging from 1.33 to 2.25 times compared with MHNw; MHOb ranged from 1.47 to 2.33 times; MUOb ranged from 2.31 to 2.67 times (all p < .05). For diabetes, the MUNw had an increased risk ranging from 2.27 to 11.93 times compared with MHNW; MHOb ranged from 1.36 to 1.95 times; MUOb ranged from 3.60 to 18.45 times (all p < .05). Our study findings revealed that AHA/NHLBI-02 and NCEP-02 can be the best diagnostic classifications criteria for cardiometabolic diseases risk factors.