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Characteristics of metabolically obese, normal-weight women differ by menopause status: the Fourth Korea National Health and Nutrition Examination Survey

Choi, Jin-Young1; Ha, Hee Sung PhD2; Kwon, Hyuk-Sang MD, PhD3; Lee, Seung-Hwan MD, PhD3; Cho, Hyun-Hee MD, PhD4; Yim, Hyeon Woo MD, PhD2; Lee, Won-Chul MD, DrMedSci2; Park, Yong-Moon MD, MS, PhD2

doi: 10.1097/gme.0b013e31825d26b6
Original Articles

Objective: People with metabolically obese, normal-weight (MONW) phenotype, characterized by insulin resistance, are vulnerable to cardiovascular disease even though they are not physically obese. We assessed whether the characteristics of the MONW phenotype differed by menopause status in Korean women.

Methods: A nationally representative sample of 1,736 Korean women aged 19 years or older (1,197 premenopausal women and 539 postmenopausal women), without diabetes, and with a body mass index of 18.5 to less than 25 kg/m2 were randomly selected from the Fourth Korean National Health and Nutrition Examination Survey in 2008. MONW individuals were defined as those included in the highest quartile of a homeostatic model assessment of insulin resistance.

Results: The prevalence of the MONW phenotype was highest (23.8%) in young women (<30 y) and decreased with age in premenopausal women. In postmenopausal women, there was a sharp increase in the prevalence of the MONW phenotype after the age of 60 years. After adjustment for covariates, including age, we found that young age, rural residence, high body mass index, high systolic blood pressure, low high-density lipoprotein cholesterol, high white blood cell count, and lack of regular exercise were significantly associated with the MONW phenotype in premenopausal women. However, for postmenopausal women, alanine aminotransferase was the only predictor that was independently associated with the MONW phenotype.

Conclusions: The characteristics of the MONW phenotype seem to vary between premenopausal and postmenopausal women. This suggests that optimal clinical approaches to preventing cardiovascular disease in women with the MONW phenotype may differ according to menopause status.

The characteristics of the metabolically obese, normal-weight (MONW) phenotype seem to vary between premenopausal and postmenopausal women. This suggests that optimal clinical approaches to preventing cardiovascular disease in women with the MONW phenotype may differ according to menopause status.

From the 1College of Medicine, 2Department of Preventive Medicine, College of Medicine, 3Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, and 4Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Received January 30, 2012; revised and accepted May 1, 2012.

Funding/support: This work was supported by research grants from the Catholic Medical Center Research Foundation in the program year of 2011.

Financial disclosure/conflicts of interest: None reported.

Jin-Young Choi and Hee Sung Ha contributed equally to this work.

J.-Y.C. wrote the manuscript and interpreted the data. H.S.H. contributed to data management, statistical analysis, and interpretation of the data. H.-S.K., S.-H.L., and H.-H.C. reviewed and edited the manuscript and contributed to the discussion. H.W.Y. and W.-C.L. reviewed the manuscript and contributed to the discussion. Y.-M.P. contributed to the study concept, critical revisions of the manuscript, and study supervision.

Address correspondence to: Yong-Moon Park, MD, MS, PhD, Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul 137-701, Korea. E-mail: markYMpark@gmail.com

© 2013 by The North American Menopause Society.