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Nayeon Choi 1 Article
Body mass index and prevalence of metabolic syndrome among Korean adults before and after the COVID-19 outbreak: a retrospective longitudinal study
Joo-Eun Jeong, Hoon-Ki Park, Hwan-Sik Hwang, Kye-Yeung Park, Myoung-Hye Lee, Seon-Hi Shin, Nayeon Choi
Epidemiol Health. 2023;45:e2023081.   Published online August 29, 2023
DOI: https://doi.org/10.4178/epih.e2023081
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Abstract
OBJECTIVES
Studies evaluating weight changes during the coronavirus disease 2019 (COVID-19) pandemic have yielded inconsistent results, and most of those studies were based on self-reported anthropometric measures. We investigated changes in body mass index (BMI), professionally measured waist circumference (WC), and metabolic syndrome components from before to during the pandemic in a sample of the adult population in Korea.
METHODS
This retrospective study included 1,118 male and female (age≥18 years) who underwent health checkups at a university medical center between January 1, 2016 and March 31, 2022. Changes in BMI, lifestyles, and metabolic syndrome components during the pandemic were analyzed using the paired t-test, McNemar test, generalized estimating equations, and repeated-measures analysis of variance.
RESULTS
Changes in body weight, BMI, and body fat percentage during the pandemic were not clinically significant. However, statistically significant results were found for decreased physical activity (p<0.001) and WC (p<0.001), and exacerbation of all metabolic syndrome components (except serum triglyceride levels). Moreover, the metabolic syndrome prevalence increased significantly from 20.2% to 31.2% during the pandemic (p<0.001). The prevalence of abdominal obesity and high fasting blood glucose levels also significantly increased from 2019 to 2021.
CONCLUSIONS
Metabolic syndrome, its components, and fat distribution worsened significantly after the implementation of social distancing and lockdowns, despite no clinically significant changes in body weight and BMI. Further studies on the post- pandemic period should investigate the long-term impact of social lockdowns on BMI and the prevalence of metabolic syndrome.
Summary
Korean summary
본 연구에서는 한국인 성인들의 코로나 팬대믹으로 인한 사회적 거리 두기, 봉쇄 정책 전 후의 체질량지수, 생활습관, 그리고 대사증후군과 그 구성 요소들의 변화를 건강검진을 통해 측정한 객관적인 지표의 변화를 통해 알아보고자 하였다. 연구 결과, 사회적 거리 두기 및 봉쇄 전후의 체질량지수와 체중은 유의미한 변화가 없었으나, 신체 활동량은 유의미하게 감소하였고, 체지방률, 허리둘레가 늘어났다. 그리고 중성지방을 제외하고 다른 대사증후군의 구성 요소인 혈압, 고밀도지단백 콜레스테롤, 공복혈당 지표는 악화되었다. 하위 그룹 분석에서 매년 검진을 시행 받은 대상자들 및 고혈압, 당뇨병, 이상지질혈증 약을 복용하지 않는 대상자들의 코로나-19 전후 연도별 대사 지표의 변화를 분석한 결과, 복부비만 유병률과 공복 혈당의 증가 양상이 뚜렷하였다.
Key Message
Although there was no significant change in BMI and weight, the prevalence of metabolic syndrome, abdominal obesity, and fasting blood glucose level prominently worsened after the implementation of social distancing and lockdowns. Such findings may indicate deterioration of insulin resistance during the COVID-19 pandemic. This study provides valuable information for healthcare professionals, policymakers, and the general public towards mitigating the negative consequences of the pandemic on metabolic health, regardless of weight gain.

Epidemiol Health : Epidemiology and Health