{
  "abstract": "BACKGROUND: The prognostic implications of abdominal obesity and moderate-to-vigorous physical activity (MVPA) in patients with type 2 diabetes who have a normal body mass index remain unclear. METHODS: ) between January 1, 2010, and December 31, 2023, from the Korean National Health Insurance Service database. Abdominal obesity was defined using sex-specific waist circumference thresholds (≥90 cm for men, ≥80 cm for women). MVPA was assessed through standardized self-reported questionnaires administered during routine health screenings. The primary outcome was major adverse cardiovascular and cerebrovascular events, defined as a composite of all-cause death, myocardial infarction, ischemic stroke, or hospitalization for heart failure. RESULTS: Among the study population, 34 033 (10.5%) had abdominal obesity. During a median follow-up of 6.0 years (interquartile range, 2.6-9.0 years), abdominal obesity was associated with a higher risk of major adverse cardiovascular and cerebrovascular events (adjusted hazard ratio [HR], 1.13 [95% CI, 1.09-1.17]). Among patients with abdominal obesity, regular MVPA after diagnosis (27.1%) was associated with a significantly lower risk of major adverse cardiovascular and cerebrovascular events (adjusted HR 0.74 [95% CI, 0.68-0.80]), all-cause mortality (adjusted HR 0.72 [95% CI, 0.65-0.80]), ischemic stroke (adjusted HR 0.77 [95% CI, 0.66-0.89]), and hospitalization for heart failure (adjusted HR 0.75 [95% CI, 0.60-0.93]). The cardiovascular protective effects of MVPA were consistent regardless of statin or antidiabetic medication use. CONCLUSIONS: In patients with type 2 diabetes and a normal body mass index, abdominal obesity was independently associated with a higher risk of major adverse cardiovascular and cerebrovascular events. Regular engagement in MVPA showed consistent cardiovascular benefits in this population, irrespective of pharmacotherapy. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT07071545.",
  "abstract_shown": true,
  "affiliations": [
    "Korea University Anam Hospital",
    "Sungkyunkwan University School of Medicine",
    "Sungkyunkwan University",
    "Jeonbuk National University Medical School"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Onyou Kim",
      "orcid": "0009-0001-3833-3789"
    },
    {
      "affs": [
        1
      ],
      "name": "Yong Hwan Park"
    },
    {
      "affs": [
        2
      ],
      "name": "Soo Yeon Kim",
      "orcid": "0000-0001-6602-3027"
    },
    {
      "affs": [
        2,
        1
      ],
      "name": "Myeongcheol Lee",
      "orcid": "0009-0006-7185-9471"
    },
    {
      "affs": [
        3
      ],
      "name": "Wonchang Hahn",
      "orcid": "0009-0003-2778-8803"
    },
    {
      "affs": [
        3
      ],
      "name": "Chang Hoon Kim",
      "orcid": "0000-0003-4603-1956"
    },
    {
      "affs": [
        2,
        1
      ],
      "name": "Danbee Kang",
      "orcid": "0000-0003-0244-7714"
    },
    {
      "affs": [
        1
      ],
      "name": "Ki Hong Choi",
      "orcid": "0000-0001-7511-9581"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9q9bfezaza5am.bib",
  "cited_by": 0,
  "doi": "10.1161/jaha.126.052821",
  "fulltext_url": null,
  "id": "9q9bfezaza5am",
  "issns": [
    "2047-9980"
  ],
  "landing_url": "https://www.ahajournals.org/doi/10.1161/JAHA.126.052821",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2712|Diabetes, Cardiovascular Risks, and Lipoproteins"
    ]
  ],
  "openalex": "W7223326596",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-23",
  "publisher": "Ovid Technologies (Wolters Kluwer Health)",
  "ris": "https://research.draconitic.com/paper/9q9bfezaza5am.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:28Z",
      "native_id": "10.1161/jaha.126.052821",
      "source": "crossref",
      "url": "https://www.ahajournals.org/doi/10.1161/JAHA.126.052821"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Diabetes, Cardiovascular Risks, and Lipoproteins",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Physical Activity and Cardiovascular Risk in Type 2 Diabetes With Normal Body Mass Index and Abdominal Obesity: A Nationwide Cohort Study",
  "title_text": "Physical Activity and Cardiovascular Risk in Type 2 Diabetes With Normal Body Mass Index and Abdominal Obesity: A Nationwide Cohort Study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:28Z",
  "url": "https://research.draconitic.com/paper/9q9bfezaza5am",
  "venue": "Journal of the American Heart Association",
  "versions": []
}