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Review Article
Obesity and Metabolism
Metabolically Healthy and Unhealthy Normal Weight and Obesity
Norbert Stefan
Endocrinol Metab. 2020;35(3):487-493.   Published online August 20, 2020
DOI: https://doi.org/10.3803/EnM.2020.301
  • 9,084 View
  • 437 Download
  • 31 Web of Science
  • 30 Crossref
AbstractAbstract PDFPubReader   ePub   
Increased fat mass is an established risk factor for the cardiometabolic diseases type 2 diabetes and cardiovascular disease (CVD) and is associated with increased risk of all-cause and CVD mortality. However, also very low fat mass associates with such an increased risk. Whether impaired metabolic health, characterized by hypertension, dyslipidemia, hyperglycemia, insulin resistance, and subclinical inflammation, may explain part of the elevated risk of cardiometabolic diseases that is found in many subjects with very low fat mass, as it does in many obese subjects, is unknown. An important pathomechanism of impaired metabolic health is disproportionate fat distribution. In this article the risk of cardiometabolic diseases and mortality in subjects with metabolically healthy and unhealthy normal weight and obesity is summarized. Furthermore, the change of metabolic health during a longer period of follow-up and its impact on cardiometabolic diseases is being discussed. Finally, the implementation of the concept of metabolic health in daily clinical practice is being highlighted.

Citations

Citations to this article as recorded by  
  • Phenotyping obesity: A focus on metabolically healthy obesity and metabolically unhealthy normal weight
    Rachel Agius, Nikolai P. Pace, Stephen Fava
    Diabetes/Metabolism Research and Reviews.2024;[Epub]     CrossRef
  • Comparing verum and sham acupoint catgut embedding for adults with obesity: A systematic review and meta-analysis of randomized clinical trials
    Jin-huan Yue, Xiao-ling Li, Yu-ying Zhang, Guan-hu Yang, Jeffrey Zhong-xue Mah, Ang Li, Wei-wei Zhao, Yu-lin Wang, Qin-hong Zhang, Jia-qi Huang
    Medicine.2024; 103(4): e36653.     CrossRef
  • Association between Weight Change and Incidence of Dyslipidemia in Young Adults: A Retrospective Cohort Study of Korean Male Soldiers
    Joon-Young Yoon, Won Ju Park, Hee Kyung Kim, Ho-Cheol Kang, Cheol-Kyu Park, Wonsuk Choi
    Journal of Obesity & Metabolic Syndrome.2024; 33(1): 36.     CrossRef
  • Metabolically Healthy Obesity: An Eye-opener
    Purushothaman Padmanabhan, Nagendram Dinakaran, Somnath Verma, S Keerthana
    Gastroenterology, Hepatology and Endoscopy Practice.2023; 3(1): 1.     CrossRef
  • Effect of metabolic health and obesity on all-cause death and CVD incidence in Korean adults: a retrospective cohort study
    Ye-Seul Kim, Sang-Jun Shin, Yonghwan Kim, Joungyoun Kim, Hee-Taik Kang
    Scientific Reports.2023;[Epub]     CrossRef
  • Coffee and metabolic phenotypes: A cross-sectional analysis of the Japan multi-institutional collaborative cohort (J-MICC) study
    Takeshi Watanabe, Kokichi Arisawa, Tien Van Nguyen, Masashi Ishizu, Sakurako Katsuura-Kamano, Asahi Hishida, Takashi Tamura, Yasufumi Kato, Rieko Okada, Rie Ibusuki, Chihaya Koriyama, Sadao Suzuki, Takahiro Otani, Teruhide Koyama, Satomi Tomida, Kiyonori
    Nutrition, Metabolism and Cardiovascular Diseases.2023; 33(3): 620.     CrossRef
  • Metabolically unhealthy phenotype in adults with normal weight: Is cardiometabolic health worse off when compared to adults with obesity?
    Myong-Won Seo, Joon Young Kim
    Obesity Research & Clinical Practice.2023; 17(2): 116.     CrossRef
  • Association between metabolic obesity phenotypes and multiple myeloma hospitalization burden: A national retrospective study
    Yue Zhang, Xiude Fan, Chunhui Zhao, Zinuo Yuan, Yiping Cheng, Yafei Wu, Junming Han, Zhongshang Yuan, Yuanfei Zhao, Keke Lu
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • Metabolically healthy obesity: Misleading phrase or healthy phenotype?
    Cem Tanriover, Sidar Copur, Abduzhappar Gaipov, Batu Ozlusen, Rustu E. Akcan, Masanari Kuwabara, Mads Hornum, Daniel H. Van Raalte, Mehmet Kanbay
    European Journal of Internal Medicine.2023; 111: 5.     CrossRef
  • Prevalence of combined metabolic health and weight status by various diagnosis criteria and association with cardiometabolic disease in Korean adults
    Myong-Won Seo, Jung-Min Lee, Hyun Chul Jung
    Obesity Research & Clinical Practice.2023; 17(2): 137.     CrossRef
  • Precision medicine in complex diseases—Molecular subgrouping for improved prediction and treatment stratification
    Åsa Johansson, Ole A. Andreassen, Søren Brunak, Paul W. Franks, Harald Hedman, Ruth J. F. Loos, Benjamin Meder, Erik Melén, Craig E. Wheelock, Bo Jacobsson
    Journal of Internal Medicine.2023; 294(4): 378.     CrossRef
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    Armella Zadoorian, Ximing Du, Hongyuan Yang
    Nature Reviews Endocrinology.2023; 19(8): 443.     CrossRef
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    Dariusz Szukiewicz
    International Journal of Molecular Sciences.2023; 24(12): 9818.     CrossRef
  • Insulin Resistance Is the Main Characteristic of Metabolically Unhealthy Obesity (MUO) Associated with NASH in Patients Undergoing Bariatric Surgery
    Sophia M. Schmitz, Sebastian Storms, Alexander Koch, Christine Stier, Andreas Kroh, Karl P. Rheinwalt, Sandra Schipper, Karim Hamesch, Tom F. Ulmer, Ulf P. Neumann, Patrick H. Alizai
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  • Predictable Representation of Metabolic Synthesis Pathways of Vitamins and Short-Chain Fatty Acids in Obese Adults
    A. V. Shestopalov, L. A. Ganenko, I. M. Kolesnikova, T. V. Grigoryeva, I. Yu. Vasilyev, Yu. L. Naboka, N. I. Volkova, O. V. Borisenko, S. A. Roumiantsev
    Journal of Evolutionary Biochemistry and Physiology.2023; 59(5): 1510.     CrossRef
  • Metabolically unhealthy individuals, either with obesity or not, have a higher risk of critical coronavirus disease 2019 outcomes than metabolically healthy individuals without obesity
    Nam Hoon Kim, Kyeong Jin Kim, Jimi Choi, Sin Gon Kim
    Metabolism.2022; 128: 154894.     CrossRef
  • Associations between obesity, metabolic syndrome, and endometrial cancer risk in East Asian women
    Boyoung Park
    Journal of Gynecologic Oncology.2022;[Epub]     CrossRef
  • Insulin and cancer: a tangled web
    Brooks P. Leitner, Stephan Siebel, Ngozi D. Akingbesote, Xinyi Zhang, Rachel J. Perry
    Biochemical Journal.2022; 479(5): 583.     CrossRef
  • Relationships Between Metabolic Body Composition Status and Rapid Kidney Function Decline in a Community-Based Population: A Prospective Observational Study
    Shao-Chi Chu, Po-Hsi Wang, Kuan-Ying Lu, Chia-Chun Ko, Yun-Hsuan She, Chin-Chan Lee, I-Wen Wu, Chiao-Yin Sun, Heng-Jung Hsu, Heng-Chih Pan
    Frontiers in Public Health.2022;[Epub]     CrossRef
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  • Metabolic and Obesity Phenotype Trajectories in Taiwanese Medical Personnel
    Hsin-Yun Chang, Jer-Hao Chang, Yin-Fan Chang, Chih-Hsing Wu, Yi-Ching Yang
    International Journal of Environmental Research and Public Health.2022; 19(13): 8184.     CrossRef
  • Sex Differences in Cardiovascular Impact of Early Metabolic Impairment: Interplay between Dysbiosis and Adipose Inflammation
    Haneen S. Dwaib, Ibrahim AlZaim, Ghina Ajouz, Ali H. Eid, Ahmed El-Yazbi
    Molecular Pharmacology.2022; 102(1): 60.     CrossRef
  • Reduced leukocyte mitochondrial copy number in metabolic syndrome and metabolically healthy obesity
    Rachel Agius, Nikolai Paul Pace, Stephen Fava
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Changes in BMI and physical activity from youth to adulthood distinguish normal-weight, metabolically obese adults from those who remain healthy
    A. Viitasalo, K. Pahkala, T. Lehtimäki, JSA. Viikari, TH. Tammelin, O. Raitakari, TO. Kilpeläinen
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Pathogenesis, Murine Models, and Clinical Implications of Metabolically Healthy Obesity
    Yun Kyung Cho, Yoo La Lee, Chang Hee Jung
    International Journal of Molecular Sciences.2022; 23(17): 9614.     CrossRef
  • Metabolically healthy obesity: it is time to consider its dynamic changes
    Yun Kyung Cho, Chang Hee Jung
    Cardiovascular Prevention and Pharmacotherapy.2022; 4(4): 123.     CrossRef
  • Obesity as a Risk Factor for Breast Cancer—The Role of miRNA
    Karolina Hanusek, Jakub Karczmarski, Anna Litwiniuk, Katarzyna Urbańska, Filip Ambrozkiewicz, Andrzej Kwiatkowski, Lidia Martyńska, Anita Domańska, Wojciech Bik, Agnieszka Paziewska
    International Journal of Molecular Sciences.2022; 23(24): 15683.     CrossRef
  • Propensity Score–Matching Sleeve Gastrectomy (SG) vs. Gastric Bypass (RYGB) in Patients ≥ 60 Years
    Omar Thaher, Stefanie Wolf, Martin Hukauf, Christine Stroh
    Obesity Surgery.2021; 31(6): 2682.     CrossRef
  • Associations between obesity, metabolic health, and the risk of breast cancer in East Asian women
    Boyoung Park, Soyeoun Kim, Hayoung Kim, Chihwan Cha, Min Sung Chung
    British Journal of Cancer.2021; 125(12): 1718.     CrossRef
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Original Articles
Association between Body Weight Changes and Menstrual Irregularity: The Korea National Health and Nutrition Examination Survey 2010 to 2012
Kyung Min Ko, Kyungdo Han, Youn Jee Chung, Kun-Ho Yoon, Yong Gyu Park, Seung-Hwan Lee
Endocrinol Metab. 2017;32(2):248-256.   Published online June 23, 2017
DOI: https://doi.org/10.3803/EnM.2017.32.2.248
  • 9,693 View
  • 72 Download
  • 14 Web of Science
  • 14 Crossref
AbstractAbstract PDFPubReader   
Background

Menstrual irregularity is an indicator of endocrine disorders and reproductive health status. It is associated with various diseases and medical conditions, including obesity and underweight. We aimed to assess the association between body weight changes and menstrual irregularity in Korean women.

Methods

A total of 4,621 women 19 to 54 years of age who participated in the 2010 to 2012 Korea National Health and Nutrition Examination Survey were included in this study. Self-reported questionnaires were used to collect medical information assessing menstrual health status and body weight changes. Odds ratios (ORs) and 95% confidence interval (CI) were calculated to evaluate the association between body weight changes and menstrual irregularity.

Results

Significantly higher ORs (95% CI) were observed in the association between menstrual irregularity and both weight loss (OR, 1.74; 95% CI, 1.22 to 2.48) and weight gain (OR, 1.45; 95% CI, 1.13 to 1.86) after adjusting for age, body mass index, current smoking, heavy alcohol drinking, regular exercise, calorie intake, education, income, metabolic syndrome, age of menarche, parity, and stress perception. Of note, significant associations were only observed in subjects with obesity and abdominal obesity, but not in non-obese or non-abdominally obese subjects. U-shaped patterns were demonstrated in both obese and abdominally obese subjects, indicating that greater changes in body weight are associated with higher odds of menstrual irregularity.

Conclusion

We found a U-shaped pattern of association between body weight changes and menstrual irregularity among obese women in the general Korean population. This result indicates that not only proper weight management but also changes in body weight may influence the regulation of the menstrual cycle.

Citations

Citations to this article as recorded by  
  • Metabolic hormones are integral regulators of female reproductive health and function
    Faria Athar, Muskan Karmani, Nicole M. Templeman
    Bioscience Reports.2024;[Epub]     CrossRef
  • Efficacy Confirmation Test of Black Cumin (Nigella sativa L.) Seeds Extract Using a High-Fat Diet Mouse Model
    Khawaja Muhammad Imran Bashir, Joo Wan Kim, Jong-Kyu Kim, Yoon-Seok Chun, Jae-Suk Choi, Sae-Kwang Ku
    Metabolites.2023; 13(4): 501.     CrossRef
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    Jung-Hee Kim, Oksoo Kim, Heeja Jung, Yanghee Pang, Hyunju Dan
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    Priya Sharma, Mandeep Kaur, Sachin Kumar, Preeti Khetarpal
    Journal of Psychosomatic Obstetrics & Gynecology.2022; 43(3): 349.     CrossRef
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    Liya Haile, Niels van de Roemer, Kristina Gemzell-Danielsson, Josep Perelló Capó, Iñaki Lete Lasa, Silvia Vannuccini, Martin C. Koch, Thomas Hildebrandt, Joaquim Calaf
    The European Journal of Contraception & Reproductive Health Care.2022; 27(2): 102.     CrossRef
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    Shweta Singh, Avadhesh Diwakar
    INDIAN JOURNAL OF APPLIED RESEARCH.2022; : 5.     CrossRef
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    Khalida Itriyeva
    Current Problems in Pediatric and Adolescent Health Care.2022; 52(8): 101241.     CrossRef
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    Olivia Raglan, David A. MacIntyre, Anita Mitra, Yun S. Lee, Ann Smith, Nada Assi, Jaya Nautiyal, Sanjay Purkayastha, Marc J. Gunter, Hani Gabra, Julian R. Marchesi, Phillip R. Bennett, Maria Kyrgiou
    Microbiome.2021;[Epub]     CrossRef
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    Nicola Tempest, Damitha N Edirisinghe, Steven Lane, Dharani K Hapangama
    European Journal of Obstetrics & Gynecology and Reproductive Biology.2021; 265: 137.     CrossRef
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    O.S. Payenok
    INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine).2021; 17(7): 575.     CrossRef
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    Eleanor P Thong, Ethel Codner, Joop S E Laven, Helena Teede
    The Lancet Diabetes & Endocrinology.2020; 8(2): 134.     CrossRef
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    Andi Asmawati Azis, N Kurnia, Hartati, Andi Bida Purnamasari
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    Jung Hee Kim
    Endocrinology and Metabolism.2017; 32(2): 219.     CrossRef
  • Nutritional Counseling Promotes Changes in the Dietary Habits of Overweight and Obese Adolescents with Polycystic Ovary Syndrome
    Adriana Lúcia Carolo, Maria Célia Mendes, Ana Carolina Japur de Sá Rosa e Silva, Carolina Sales Vieira, Marcos Felipe Silva de Sá, Rui Alberto Ferriani, Rosana Maria dos Reis
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Close layer
Obesity and Metabolism
Sugar-Sweetened Beverage Consumption Is Associated with Metabolic Syndrome in Iranian Adults: Tehran Lipid and Glucose Study
Hanieh-Sadat Ejtahed, Zahra Bahadoran, Parvin Mirmiran, Fereidoun Azizi
Endocrinol Metab. 2015;30(3):334-342.   Published online May 18, 2015
DOI: https://doi.org/10.3803/EnM.2015.30.3.334
  • 3,936 View
  • 33 Download
  • 22 Web of Science
  • 23 Crossref
AbstractAbstract PDFPubReader   
Background

Metabolic syndrome (MetS), a cluster of multiple metabolic abnormalities, is one of the major public health challenges worldwide. The current study was conducted to evaluate the association between sugar-sweetened beverage (SSB) consumption and MetS and its components in Iranian adults.

Methods

This cross-sectional study was conducted among 5,852 men and women, aged 19 to 70 years, who participated in the fourth phase (2009 to 2011) of the Tehran Lipid and Glucose Study. Demographics, anthropometrics, biochemical measurements, and blood pressure (BP) were assessed and MetS was defined by National Cholesterol Education Program Adult Treatment Panel III definition. Frequency and quantity of SSB intakes including carbonated drinks and synthetic fruit juices were collected using a validated semiquantitative food frequency questionnaire.

Results

Mean age of participants (43%, men) was 40.6±12.9 years. Significant positive associations between SSBs and waist circumference, triglyceride level, systolic and diastolic BP in the third and fourth quartile of SSBs were observed, after adjustment for all potential confounding variables. The odds of MetS in the third and fourth quartiles compared to the first quartile category of SSBs was 1.21 (95% confidence interval [CI], 1.01 to 1.45) and 1.30 (95% CI, 1.06 to 1.58), respectively (P for trend=0.03). The odds of MetS, abdominal obesity, low high density lipoprotein cholesterol and elevated BP had increasing trends across increasing of SSB consumption (P for trend <0.05).

Conclusion

Higher intake of SSBs was associated with the higher odds of MetS in adults. It is suggested that reducing consumption of SSBs could be a practical approach to prevent metabolic abnormalities.

Citations

Citations to this article as recorded by  
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    Danielle Cristina Guimarães da Silva, Wellington Segheto, Fernanda Cristina da Silva Amaral, Nínive de Almeida Reis, Ghéssica Santana Silva Veloso, Milene Cristine Pessoa, Juliana Farias de Novaes, Giana Zarbato Longo
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Review Article
Obesity and Metabolism
Optimal Waist Circumference Cutoff Values for the Diagnosis of Abdominal Obesity in Korean Adults
Yeong Sook Yoon, Sang Woo Oh
Endocrinol Metab. 2014;29(4):418-426.   Published online December 29, 2014
DOI: https://doi.org/10.3803/EnM.2014.29.4.418
  • 5,857 View
  • 70 Download
  • 65 Web of Science
  • 71 Crossref
AbstractAbstract PDFPubReader   

Abdominal obesity is associated closely with insulin resistance, diabetes, and cardiovascular disease. Waist circumference (WC) is a useful surrogate marker commonly used for abdominal adiposity. The determination of WC cutoff levels is important in the prevention and treatment of obesity, type 2 diabetes, and related cardiovascular diseases. Recent epidemiological evidence suggested that appropriate optimal cutoffs for Koreans ranged over 80 to 89.8 cm in males and 76.1 to 86.5 cm in females. We analyzed the data from two large cohorts using receiver operating characteristic curve analysis with the incidences of diabetes, hypertension, dyslipidemia, cerebrovascular disease, myocardial infarct, angina, coronary artery disease, and multiple metabolic risk factors as outcome variables. Optimal WC cutoff points for Koreans were 85 cm in males and 80 cm in females. However, considering the prevalence of abdominal obesity and the health costs for its prevention and management, 90 cm in males and 85 cm in females are probably more appropriate thresholds for abdominal obesity. These values may be modified once better research is performed through prospective studies using representative populations, common health outcomes, and proper analytical approaches.

Citations

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    Phatcharaphon Whaikid, Noppawan Piaseu
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    Jue Seong Lee, Eun-Saem Choi, Hwasun Lee, Serhim Son, Kwang-Sig Lee, Ki Hoon Ahn
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Close layer
Original Article
Obesity and Metabolism
The Relationship of Body Composition and Coronary Artery Calcification in Apparently Healthy Korean Adults
Jung-Hee Yu, Seo Hyoung Yim, Su Hyeon Yu, Ji Yong Lee, Jong Dae Kim, Mi Hae Seo, Won Seon Jeon, Se-Eun Park, Cheol-Young Park, Won-Young Lee, Ki-Won Oh, Sung-Woo Park, Eun-Jung Rhee
Endocrinol Metab. 2013;28(1):33-40.   Published online March 25, 2013
DOI: https://doi.org/10.3803/EnM.2013.28.1.33
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

We investigated the association of coronary artery calcium score (CACS) with body composition and insulin resistance in apparently healthy Korean adults.

Methods

Nine hundred forty-five participants (mean age, 48.9 years; 628 men) in a medical check-up program were selected for analysis. Body composition was assessed by bioelectrical impedance analysis (BIA). Insulin resistance was evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR). The CACS was assessed by multidetector computed tomography.

Results

One hundred forty-six subjects (15.4%) showed coronary artery calcification and 148 subjects (15.7%) had metabolic syndrome. CACS showed a significant positive correlation with age, fasting glucose level, waist circumference (WC), blood pressure, hemoglobin A1c, HOMA-IR, and waist-hip ratio (WHR) assessed by BIA. CACS had a negative correlation with high density lipoprotein cholesterol (HDL-C). Subjects with high CACS showed significantly higher mean WHRs and lower mean values for lean body mass compared with subjects without coronary artery calcification. In logistic regression analyses with coronary artery calcification as the dependent variable, the highest quartile of WHR showed a 3.125-fold increased odds ratio for coronary artery calcification compared with the lowest quartile after adjustment for confounding variables. When receiver operating characteristics analyses were performed with coronary artery calcification as the result variable, WHR showed the largest area under the curve (AUC) value among other variables except for age and WC in women (AUC=0.696 for WHR, 0.790 for age, and 0.719 for WC in women).

Conclusion

In our study population of apparently healthy Korean adults, WHR was the most significant predictor for coronary artery calcification among other confounding factors, suggesting that it may have implication as a marker for early atherosclerosis.

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    Stroke.2015; 46(1): 151.     CrossRef
  • Metabolic syndrome criteria as predictors of subclinical atherosclerosis based on the coronary calcium score
    Mi Hae Seo, Eun-Jung Rhee, Se Eun Park, Cheol Young Park, Ki Won Oh, Sung Woo Park, Won-Young Lee
    The Korean Journal of Internal Medicine.2015; 30(1): 73.     CrossRef
  • Statin eligibility and cardiovascular risk burden assessed by coronary artery calcium score: Comparing the two guidelines in a large Korean cohort
    Eun-Jung Rhee, Se Eun Park, Hyung Geun Oh, Cheol-Young Park, Ki-Won Oh, Sung-Woo Park, Ron Blankstein, Jorge Plutzky, Won-Young Lee
    Atherosclerosis.2015; 240(1): 242.     CrossRef
  • Relationship of Glycated Hemoglobin A1c, Coronary Artery Calcification and Insulin Resistance in Males Without Diabetes
    Chan-Hee Jung, Eun-Jung Rhee, Kyu-Jin Kim, Bo-Yeon Kim, Se Eun Park, Yoosoo Chang, Seungho Ryu, Cheol-Young Park, Ji-Oh Mok, Ki-Won Oh, Chul-Hee Kim, Sung-Woo Park, Sung-Koo Kang, Won-Young Lee
    Archives of Medical Research.2015; 46(1): 71.     CrossRef
  • Metabolic Health Is a More Important Determinant for Diabetes Development than Simple Obesity: A 4-Year Retrospective Longitudinal Study
    Eun-Jung Rhee, Min Kyung Lee, Jong Dae Kim, Won Seon Jeon, Ji Cheol Bae, Se Eun Park, Cheol-Young Park, Ki-Won Oh, Sung-Woo Park, Won-Young Lee, Reury F. P. Bacurau
    PLoS ONE.2014; 9(5): e98369.     CrossRef
  • Brief Review of Articles in 'Endocrinology and Metabolism' in 2013
    Won-Young Lee
    Endocrinology and Metabolism.2014; 29(3): 251.     CrossRef
  • Letter: The Relationship of Body Composition and Coronary Artery Calcification in Apparently Healthy Korean Adults (Endocrinol Metab 2013;28:33-40, Jung-Hee Yu et al.)
    Han Seok Choi
    Endocrinology and Metabolism.2013; 28(2): 153.     CrossRef
  • Metabolic Health Is More Closely Associated with Coronary Artery Calcification than Obesity
    Eun-Jung Rhee, Mi Hae Seo, Jong Dae Kim, Won Seon Jeon, Se Eun Park, Cheol-Young Park, Ki-Won Oh, Sung-Woo Park, Won-Young Lee, Rozemarijn Vliegenthart
    PLoS ONE.2013; 8(9): e74564.     CrossRef
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