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Kimetal.DiabetolMetabSyndr(2015)7:68DOI10.1186/s13098-015-0063-yRESEARCHObesitywithmetabolicabnormalityisassociatedwiththepresenceofcarotidatherosclerosisinKoreanmen:across-sectionalstudyHa‑NaKim,Se‑HongKim,Young‑MiEunandSang‑WookSong*AbstractBackground:Obesityisariskfactorforcardiovasculardisease,butmetabolicdisturbancescanalsoleadtothedevel‑opmentofthisdisease.Therefore,weinvestigatedtheassociationsbetweenobesitysubtype,consideringbothbodyweightandmetabolicdisturbances,andcarotidatherosclerosisasapredictorofcardiovasculardiseaseinKoreanmen.Methods:Datafromatotalof980menwereanalysedinthisstudy.Obesitysubtypeswereclassifiedasnormalweightwithoutmetabolicsyndrome(metabolicallyhealthynormalweight;MHNW),obesitywithoutmetabolicsyndrome(metabolicallyhealthy,butobese;MHO),normalweightwithmetabolicsyndrome(metabolicallyabnor‑mal,butnormalweight;MANW)andobesitywithmetabolicsyndrome(metabolicallyabnormalobese;MAO).Carotidintima‑mediathickness(CIMT)andcarotidplaquewereassessedusingahigh‑resolutionB‑modeultrasoundsystem.CarotidatherosclerosiswasdefinedasameanCIMTvalue>0.9mmorthepresenceofcarotidplaque.Results:MeanCIMTintheMAOsubtypewassignificantlyhigherthanthatintheMHNWcontrolgroup(0.790±0.019vs.0.747±0.013mm;p<0.001).ThepresenceofcarotidplaquewaspositivelyassociatedwithMAOsubtype[adjustedoddsratio(aOR)1.49,95%confidenceinterval(CI)1.02–2.16;p=0.039],butnotwithMHOorMANW,comparedtotheMHNWcontrolgroup.TheMAOsubtypeshowedapositiveassociationwiththepresenceofcarotidatherosclerosis(aOR1.68,95%CI1.17–2.42;p=0.006).Conclusions:OnlytheMAOsubtypeshowedahigherCIMTvalueandpositiveassociationswithcarotidplaqueandcarotidatherosclerosis,butnotwithMHOandMANWsubtypes,comparedtotheMHNWcontrol.Additionalprospec‑tivestudiesareneededtoevaluatepreclinicalcarotidatherosclerosisaccordingtothesubtypesofobesity.Keywords:Obesity,Metabolicsyndrome,Carotidatherosclerosis,Carotidplaque,Carotidintima‑mediathickness©2015Kimetal.ThisarticleisdistributedunderthetermsoftheCreativeCommonsAttribution4.0InternationalLicense(http://creativecommons.org/licenses/by/4.0/),whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedyougiveappropriatecredittotheoriginalauthor(s)andthesource,providealinktotheCreativeCommonslicense,andindicateifchangesweremade.TheCreativeCommonsPublicDomainDedicationwaiver(http://creativecommons.org/publicdomain/zero/1.0/)appliestothedatamadeavailableinthisarticle,unlessotherwisestated.BackgroundObesity,whichisdefinedasexcessaccumulationofbodyfat,isamajorpublichealthproblemwithaprevalencethatisincreasingworldwide[1].Obesityisassociatedwithanincreasedriskofcardiometabolicdiseases,suchascardiovasculardisease(CVD)andstroke.Inaddi-tion,obesity-inducedinsulinresistanceandmetabolicabnormalitiesalsocausecardiometabolicdisease[2].However,notallobeseindividualsshowmetabolicabnormalities,andnotallnormal-weightindividualsshowfavourablemetabolicconditions.Therefore,obe-sitysubtypesdividedaccordingtometabolicstatussuchasmetabolicallyhealthybutobese(MHO),metaboli-callyabnormalbutnormalweight(MANW),andmeta-bolicallyabnormalobese(MAO)haveattractedattention[3,4].SeveralepidemiologicalstudieshavereportedCVD/strokerisksaccordingtoobesitysubtypes,buttheresultsOpenAccess*Correspondence:sswkoj@unitel.co.krDepartmentofFamilyMedicine,CollegeofMedicine,St.Vincent’sHospital,TheCatholi...