MON-228 Prevalence of Cardiometabolic Risk Factors and Metabolic Syndrome by Weight Status (Underweight to Class III Obesity) in Korean Children and Adolescents: The Korea National Health and Nutrition Examination Survey 2007-2021

Abstract Disclosure: Y. Hong: None. E. Lee: None. J. Lee: None. M. Yang: None. H. Lee: None. H. Kim: None. J. Kim: None. S. Kim: None. Background: Pediatric obesity poses a significant public health concern due to its increasing prevalence and strong association with metabolic and cardiovascular risks. This study examines the severity of obesity in Korean children and adolescents and its relationship with cardiometabolic risk factors (CMRFs). By incorporating updated national reference values for waist circumference, the research provides insights into obesity trends and associated health implications in this population. Methods: A retrospective analysis was conducted using data from the 4th to 8th Korea National Health and Nutrition Examination Survey (KNHANES) (2007–2021). Of the 120,181 participants, 11,200 aged 10–18 years with complete anthropometric and fasting laboratory data were included. Participants were categorized into five BMI-based groups: underweight, normal weight, overweight, class I obesity, and class II/III obesity. Prevalence of CMRFs, including total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, blood pressure, fasting glucose, HbA1c, and metabolic syndrome (MetS), was analyzed using IDF and modified NCEP-ATP III criteria. Results: CMRF prevalence increased significantly with higher BMI categories. MetS was not significantly associated with underweight status under either IDF or NCEP-ATP III criteria. Adjusted odds ratios (ORs) for MetS in overweight, class I, and class II/III obesity were 18.93, 47.15, and 125.68 under IDF criteria and 11.13, 29.38, and 75.57 under NCEP-ATP III criteria, respectively. Boys with class II/III obesity had higher adjusted ORs for MetS (133.87), triglycerides ≥150 mg/dL (5.99), and non-HDL-C ≥145 mg/dL (7.21). Girls in class II/III obesity exhibited elevated risks for fasting glucose ≥100 mg/dL (OR 7.66) and low HDL-C (OR 8.08). Conclusion: Higher BMI categories are strongly associated with increased CMRFs and MetS in Korean children and adolescents. Class II/III obesity poses the highest risks, with notable sex-specific differences. These findings emphasize the importance of implementing targeted interventions and prevention strategies tailored to sex-specific risk profiles. Presentation: Monday, July 14, 2025