Cardiometabolic Diseases after Weight Gain and Its Associated Factors among Korean Adults: Using National Sample Cohort

Abstract

Introduction: Research on the incidence of diabetes, hypertension, and dyslipidemia resulting from weight gain remains limited. This study examined the association between weight gain and the occurrence of cardiometabolic diseases over a mean follow-up duration of 14.5 years, considering baseline BMI categories. Additionally, we analyzed the factors contributing to weight gain in Korean adults. Methods: We analyzed the incidence of type 2 diabetes, hypertension, and dyslipidemia according to weight gain using the Cox proportional hazards model and the associated factors of weight gain through multivariable logistic regression analysis among 66, 603 adults aged 19–64 years, using data from the Korean National Health Insurance Service. Baseline body mass index (BMI) was classified into three categories: < 23, 23–24.9, and ≥ 25 kg/m2. BMI increase was categorized as < 0.3, 0.3–0.69, and ≥ 0.7 kg/m2/year. Results: The hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiometabolic diseases increased in proportion to BMI and BMI increase. The HRs (95% CIs) ranged from 1.08 (1.01–1.16) to 2.77 (2.54–3.02) for type 2 diabetes, 1.14 (1.08–1.19) to 2.60 (2.43–2.78) for hypertension, and 1.08 (1.04–1.13) to 1.85 (1.73–1.99) for dyslipidemia. Even individuals with a normal weight who experienced greater weight gain were at a higher risk of cardiometabolic diseases. The cumulative incidence rates increased proportionally with BMI and BMI increase. Younger age and lower income were risk factors in both sexes, while not being obese, heavy drinking, current smoking, and no regular exercise were risk factors for weight gain in men. Conclusion: The management of weight gain, even in adults who do not have obesity, is necessary to prevent cardiometabolic diseases.