Combined Influence of Obesity and Metabolic Syndrome on Ischemic Heart Disease in Korean middle aged and older adults

허혈성심질환 발생에 대한 대사증후군과 비만의 개별효과와 결합효과

  • Ra, Jin Suk (College of Nursing, Chungnam National University) ;
  • Kim, Hye Sun (College of Nursing, Chungnam National University)
  • Received : 2015.10.12
  • Accepted : 2015.12.17
  • Published : 2015.12.31


Purpose: The purpose of this study was to examine a combined influence of obesity and metabolic syndrome on ischemic heart disease in Korean middle aged and older adults. Methods: This study used secondary data from the 2013 Korea National Health and Nutrition Examination Survey. A total of 3,726 adults over age 40 were included. Logistic regression was used for analysis of complex samples. Gender, age, educational level, family income, family history of ischemic heart disease, physical activity, smoking, and heavy alcohol consumption were analyzed as covariates. Results: Ischemic heart disease was more prevalent among adults with metabolic syndrome regardless of obesity (non-obesity: Adjusted Odds Ratio [AOR]: 3.044, 95% Confidence Interval [CI]: 1.163-7.967, overweight: AOR: 2.805, 95% CI: 1.246-6.316, obese: AOR: 3.137, 95% CI: 1.548-6.358) compared to the reference group, defined as adults with non-obesity and non-metabolic syndrome. Odds of ischemic heart disease were not significant in the group with obesity and non-metabolic syndrome compared to the reference group. Conclusion: The results of this study show that the population with metabolic syndrome is an at-risk group for ischemic heart disease. Thus, management of metabolic syndrome is required for prevention of ischemic heart disease.


  1. Ahn, K. M. (2012). Relationship between changes of cardiopulmonary function and coronary artery calcium score in middle aged Korean men. Unpublished doctoral dissertation, Hanyang University, Seoul.
  2. Arnlov, J., Ingelsson, E., Sundstrӧm, J., & Lind, L. (2010). Impact of body mass index and the metabolic syndrome on the risk of cardiovascular disease and death in middle-aged men. Circulation, 121(2), 230-236. LATIONAHA.109.887521
  3. Canoy, D., Cairns, B. J., Balkwill, A., Wright, F. L., Green, J., Reeves, G., & Beral, V. (2013). Body mass index and incident coronary heart disease in women: a population-based prospective study. BMC medicine, 11(1), 87-95.
  4. Chei, C. L., Yamagishi, K., Tanigawa, T., Kitamura, A., Imano, H., Kiyama, M., Sato, S., & Iso, H. (2008). Metabolic syndrome and the risk of ischemic heart disease and stroke among middle-aged Japanese. Hypertension Research, 31(10), 1887-1894.
  5. Cho, S. H., Choi, M. J., & Jeong, M. H. (2012). Metabolic syndrome risk factors related to severity of coronary artery diseases in patients with acute myocardial infarction. Journal of Korean Clinical Nursing Research, 18(1), 171-181.
  6. Choi, E. J., Yoo, J. S., Kim, H. S., Oh, E. G., Kim, S., Bae, S. H., & Chu, S. H. (2007). Utilization and needs assessment of health promotion programs for middle-aged women in public health centers. Journal of Korean Public Health Nursing, 21(2), 193-205.
  7. Choi, G. Y. & Hong, E. S. (2008). Comparison of presentation in acute myocardial infarction by gender. Korean Journal of Adult Nursing, 20(1), 126-134.
  8. Choi, K. M., Cho, H. J., Choi, H. Y., Yang, S. J., Yoo, H. J., Seo, J. A., Kim, S. G., Baik, S. H., Choi, D. S., & Kim, N. H. (2013). Higher mortality in metabolically obese normal‐weight people than in metabolically healthy obese subjects in elderly Koreans. Clinical endocrinology, 79(3), 364-370.
  9. Coutinho, T., Goel, K., de Sa, D. C., Carter, R. E., Hodge, D. O., Kragelund, C., Kanaya, A. M., Zeller, M., Park, J. S., Kober, L., Torp-Pedersen, C., Cottin, Y., Lorgis, L., Lee, S. H., Kim, Y. J., Thomas, R., Roger, V. L., Somers, V. K., & Lopez-Jimenez, F. (2013). Combining body mass index with measures of central obesity in the assessment of mortality in subjects with coronary disease: role of "normal weight central obesity". Journal of the American College of Cardiology, 61(5), 553-560. 5
  10. D'Agostino Sr, R. B., Grundy, S., Sullivan, L. M., & Wilson, P. (2001). Validation of the Framingham coronary heart disease prediction scores: results of a multiple ethnic groups investigation. The Journal of the American Medical Association, 286(2), 180-187.
  11. Grundy, S. M., Brewer, H. B., Cleeman, J. I., Smith, S. C., & Lenfant, C. (2004). Definition of metabolic syndrome report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on scientific issues related to definition. National Heart, Lung, and Blood Institute & American Heart Association Conference: 109(3). Circulation (pp. 433-438).
  12. Ha, C. H., Ha, S., & So, W. Y. (2012). Effects of a 12-week combined exercise training program on the body composition, physical fitness levels, and metabolic syndrome profiles of obese women. Journal of Korean Public Health Nursing, 26(3), 417-427. 3.417
  13. Hamer, M. & Stamatakis, E. (2012). Metabolically healthy obesity and risk of all-cause and cardiovascular disease mortality. The Journal of Clinical Endocrinology & Metabolism, 97(7), 2482-2488.
  14. Van de Voorde, J., Pauwels, B., Boydens, C., & Decaluwe, K. (2013). Adipocytokines in relation to cardiovascular disease. Metabolism, 62(11), 1513-1521. 1016/j.metabol.2013.06.004
  15. Kang, J. H., Jeong, B. G., Cho, Y. G., Song, H. R., & Kim, K. A. (2010). Medical expenditure attributable to overweight and obesity in adults with ischemic heart disease and stroke in Korea. Korean Journal of Health Education and Promotion, 27(4), 83-90.
  16. Kim, M. J. & Kim, K. H. (2012). Lifestyle differences between middle-aged and old-aged patients with acute myocardial infarction. Health and Social Welfare Review, 32(1), 260-280.
  17. Kim, S. H. & Lee, S. H. (2014). Influences of knowledge, self-efficacy, and social support on sick role behavior in patients with coronary artery disease. Journal of Korean Public Health Nursing, 28(2), 228-240.
  18. Kip, K. E., Marroquin, O. C., Kelley, D. E., Johnson, B. D., Kelsey, S. F., Shaw, L. J., Rogers, W. J., & Reis, S. E. (2004). Clinical importance of obesity versus the metabolic syndrome in cardiovascular risk in women a report from the Women's Ischemia Syndrome Evaluation (WISE) study. Circulation, 109(6), 706-713.
  19. Korea Ministry of Health & Welfare, Korea Centers for Disease Control & Prevention. (2013, January). 2013 The 6th Korea National Health Nutrition Examination Survey statistics. Retrieved June 10, 2015, from U1752
  20. Korean Society for The Study of Obesity. (2012). Obesity guidelines for Korean 2012. Retrieved August 10, 2015, from
  21. Meigs, J. B., Wilson, P. W., Fox, C. S., Vasan, R. S., Nathan, D. M., Sullivan, L. M., & D'Agostino, R. B. (2006). Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. The Journal of Clinical Endocrinology & Metabolism, 91(8), 2906-2912.
  22. Nordestgaard, B. G., Timpson, N., Palmer, T., Zacho, J., Benn, M., Tybjaerg-Hansen, A., & Davey Smith, G. (2010). Increased body mass index and increased risk of ischemic heart disease: using genomewide association results to estimate causal effects with mendelian randomization. Circulation, 122 (21 Supplement), A17003.
  23. Park, H. S. (2002). Epidemiology of metabolic syndrome in Korea, Journal of Korean Society for the Study of Obesity, 11(3), 203-211.
  24. Ritchie, S. & Connell, J. M. C. (2007). The link between abdominal obesity, metabolic syndrome and cardiovascular disease. Nutrition, Metabolism and Cardiovascular Diseases, 17(4), 319-326.
  25. Saito, I., Iso, H., Kokubo, Y., Inoue, M., & Tsugane, S. (2009). Metabolic syndrome and all-cause and cardiovascular disease mortality Japan Public Health Center-Based Prospective (JPHC) study. Circulation Journal, 73(5), 878-884.
  26. Statistics Korea. (2015, September-a). 2013 National health screening statistics. Retrieved September 28, 2015, from
  27. Statistics Korea. (2015, September-b). 2014 National Death Cause statistics. Retrieved September 25, 2015, from
  28. Thomsen, M. & Nordestgaard, B. G. (2014). Myocardial infarction and ischemic heart disease in overweight and obesity with and without metabolic syndrome. The Journal of the American Medical Association Internal Medicine, 174(1), 15-22.
  29. Wildman, R. P., Muntner, P., Reynolds, K., McGinn, A. P., Rajpathak, S., Wylie-Rosett, J., & Sowers, M. R. (2008). The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). Archives of internal medicine, 168(15), 1617-1624. 617
  30. World Health Organization. (2014). The top 10 causes of death. Retrieved August 5, 2015, from heets/fs310/en/

Cited by

  1. Evaluation of the Readability and Suitability of Printed Educational Materials on Metabolic Syndrome vol.30, pp.1, 2016,