Abstract
Previous cross-sectional studies showed that immigrants from low-income to high-income countries have higher risk of cardiovascular disease and type 2 diabetes mellitus. We investigated the association between weight gain during the resettlement in South Korea and risk of metabolic syndrome (MetS) among North Korean refugees (NKRs) in this cross-sectional study. In total, 932 NKRs aged 20–80 years in South Korea voluntarily underwent health examination from 2008 to 2017. We compared the risk of MetS and its components between the weight gain group (gained ≥5 kg) and the non-weight gain group (gained <5 kg, maintained or lost body weight) during resettlement in South Korea after defection from North Korea. Multiple logistic regression analysis predicted odds ratio of MetS on the basis of weight change, adjusting for covariates and current body mass index (BMI). We also evaluated the difference in body composition of NKRs between two groups. The prevalence of MetS in the weight gain group was 26%, compared to 10% in the non-weight gain group (p-value < 0.001). The weight gain group had a two-fold higher risk of MetS than the non-weight gain group after adjusting for current BMI (odds ratio 1.875, p-value = 0.045). The prevalence of central obesity, impaired fasting glucose, elevated blood pressure, and hypertriglyceridemia were higher in the weight gain group than the non-weight gain group (36% vs. 12%, p-value < 0.001; 32% vs. 19%, p-value < 0.001; 34 vs. 25%, p-value = 0.008; 19% vs. 13%, p-value = 0.025, respectively). The analysis of body composition showed that the percentage of body fat in the weight gain group was higher than in the non-weight gain group, indicating increased fat mass rather than muscle mass in the weight gain group as their body weight increased during resettlement (33.4 ± 6.53% vs. 28.88 ± 7.40%, p < 0.005). Excess weight gain after defection from North Korea increased the risk of MetS among NKRs in South Korea. It is necessary to monitor weight change among NKRs and their effect on their metabolic health in the long term.
Highlights
IntroductionAs the prevalence of obesity has increased worldwide due to dietary change and sedentary lifestyles, the prevalence of metabolic syndrome (MetS) has rapidly increased [1]
Triglyceride, ALT levels, and blood pressure were higher in the weight gain group than non-weight gain group
Prevalence of impaired fasting glucose and elevated blood pressure were higher in the weight gain group than in the non-weight gain group (32% vs. 19%, p-value < 0.001, and 34% vs. 25%, p-value = 0.008, respectively)
Summary
As the prevalence of obesity has increased worldwide due to dietary change and sedentary lifestyles, the prevalence of metabolic syndrome (MetS) has rapidly increased [1]. MetS could be a public health problem in that it could be a risk factor for diabetes mellitus and cardiovascular disease [2,3]. Obesity is a well-known risk factor for. MetS in the general adult population [4,5,6]. Obesity is etiologically linked with chronic low-grade inflammatory conditions that contribute to the pathogenesis of metabolic dysfunction and MetS [7]. Previous studies have shown that weight gain had a significant
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