The Relationship between Metabolically Obese Non-Obese Weight and Stroke: The Korea National Health and Nutrition Examination Survey

Objective Both metabolic syndrome (MetS) and obesity increase the risk of stroke. However, few studies have compared the risks of stroke associated with metabolically obese non-obese weight (MONW) and metabolically healthy obesity (MHO). This study aimed to compare the prevalence of stroke in MONW and MHO individuals. Methods A total of 25,744 subjects aged >= 40 years were selected from the 2007-2014 Korean National Health and Nutrition Examination Survey. MetS was defined using 2001 National Cholesterol Education Program/Adult Treatment Panel III and 2005 American Heart Association/National Heart, Lung, and Blood Institute criteria. Non-obese weight and obesity were defined as a body mass index (BMI) < 25 kg/m(2) and >= 25 kg/m(2), respectively. MONW was defined as meeting the MetS criteria with a BMI < 25 kg/m(2) and MHO was defined as not meeting the MetS criteria with a BMI >= 25 kg/m(2). Results Women with MONW had a higher prevalence of stroke than those with MHO (odds ratio [OR] = 2.27, 95% confidence interval [CI]: 1.45-3.57). The prevalence of stroke increased as the number of MetS components increased. The ORs for MONW with 3, 4, and 5 MetS components were 1.95 (95% CI: 1.19-3.21), 2.49 (95% CI: 1.46-4.24) and 2.74 (95% CI: 1.39-5.40), respectively. Conclusions Our study findings may better emphasize the risk of stroke among more lean but unhealthy individuals, who appear healthy but may be suffering from MetS. These findings also highlight the need for stroke risk factor assessment in non-obese weight individuals.