Comparison of insulin resistance and metabolic syndrome criteria in metabolically obese, normal weight (MONW) individuals in the prediction of cardiovascular disease risk: analysis of the Korean National Health and Nutrition Examination Survey (KNHANES) in 2010–2012

  • Hye-Rim Hwang
  • Dong-Wook JeongEmail author
  • Yun-Jin Kim
  • Sangyeop Lee
  • Jeong-Gyu Lee
  • Yang Ho Kang
  • Yu-Hyun Yi
  • Young-Hye Cho
  • Young-Jin Tak
  • Ara Zo
Original Article


Body mass index is considered to be insufficient to diagnose obesity in population with metabolic abnormalities. In this study, we aimed to determine the optimal criteria for metabolically obese, normal weight (MONW) with insulin resistance or with metabolic syndrome to provide reliable diagnostic tool for obesity, especially targeting Korean population. This is a cross-sectional study based on the data extracted from the Korean National Health and Nutrition Examination Survey in 2010–2012. A total of 6274 adults with the normal weight were enrolled, and each subject was classified into either MONW with insulin resistance (MONW-IR) or MONW with metabolic syndrome (MONW-Mets) in order to analyze the risk of cardiovascular events. The Framingham risk score (FRS) and atherosclerotic cardiovascular disease risk equation (ASCVD) were used in the process. The odds ratio for the cardiovascular disease risk based on the FRS in the MONW-IR group (1.132; 95% confidence interval (CI), 0.854–1.502) was not significantly elevated whereas the odds ratio for the cardiovascular disease risk using the ASCVD in the MONW-IR group (1.809; 95% CI, 1.410–2.322) was significantly increased. The odds ratio for the cardiovascular disease risk in the MONW-Mets group was both significantly increased (2.93; 95% CI, 2.19–3.91 by FRS, 8.44; 95% CI, 6.19–11.49 by ASCVD) as well. However, the risk of cardiovascular disease was not significantly increased after excluding the subjects with diabetes mellitus that were the majority of MONW-IR group. Metabolic syndrome criteria can be considered more useful tool in diagnosing MONW in the Korean population. However, further prospective studies are needed to confirm our findings.


Obesity Metabolic syndrome Insulin resistance Cardiovascular risk 


Authors’ contributions

HR H and DW J collected data and drafted the manuscript. YJ K, SY L, JG L, YH K, YH Y, YH C, YJ T, and AZ performed the statistical analysis and drafted the manuscript. All authors read and approved the final manuscript

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Research Society for Study of Diabetes in India 2016

Authors and Affiliations

  • Hye-Rim Hwang
    • 1
  • Dong-Wook Jeong
    • 1
    • 2
    Email author
  • Yun-Jin Kim
    • 1
  • Sangyeop Lee
    • 1
    • 3
  • Jeong-Gyu Lee
    • 1
  • Yang Ho Kang
    • 4
    • 5
  • Yu-Hyun Yi
    • 1
  • Young-Hye Cho
    • 2
  • Young-Jin Tak
    • 1
  • Ara Zo
    • 2
  1. 1.Department of Family MedicinePusan National University School of MedicinePusanSouth Korea
  2. 2.Family Medicine ClinicPusan National University Yangsan HospitalYangsanSouth Korea
  3. 3.Medical Education UnitPusan National University School of MedicinePusanSouth Korea
  4. 4.Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Yangsan HospitalPusan National University School of MedicineYangsanSouth Korea
  5. 5.Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan HospitalYangsanSouth Korea

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