Endocrine Abstracts

JOINT1864

Objective: In South Korea, increasing stress levels resulting from political turmoil and economic instability have accelerated declines in marriage and childbirth. Assuming that post-COVID restrictions on outdoor activities adversely affected blood glucose and body weight, we evaluated metabolic health among three groups: married individuals with children (MIWC), DINKs (Dual Income, No Kids), and unmarried individuals. To exclude pregnant women, the 40–50-year-old cohort was selected.

Methods: This cross-sectional study analyzed 13,178,582 Korean adults (7,004,014 males and 6,174,568 females) aged 40–59 who participated in the Korean National Health and Nutrition Examination Survey (2020–2021). Prediabetes or diabetes was identified based on HbA1c levels, hospital diagnoses, or prescriptions for insulin or oral anti-diabetic agents. Obesity was classified into Grade 1 (25 ≤ BMI < 30 kg/m²), Grade 2 (30 ≤ BMI < 35 kg/m²), and Grade 3 (BMI ≥ 35 kg/m²). A complex sampling design and cross-tabulation analyses were used to examine socioeconomic and laboratory factors.

Results: MIWC represented 72.8% of the sample, DINKs 16.1%, and unmarried individuals 11.1%. In the MIWC group, gender distribution was approximately 51% male and 49% female; in DINKs, 47.8% male and 52.2% female; and in the unmarried group, 75.1% male and 24.9% female. DINK females exhibited a significantly higher prevalence of metabolic disorders compared to MIWC and unmarried females. Specifically, prediabetes was present in 53.4% of DINKs vs 41.1% in MIWC and 24.3% in unmarried females (P <0.001); diabetes in 13.1% vs 7.2% vs 3.7% (P = 0.005); dyslipidemia in 31.6% vs 24.0% vs 22.3% (P = 0.030); and hypertension in 26.8% vs 16.7% vs 12.8% (P = 0.001). Anthropometric and laboratory measurements paralleled these findings, with DINK females showing higher BMI, waist circumference, systolic blood pressure, HbA1c, and fasting glucose compared to unmarried females. Unmarried females had the lowest waist circumference and LDL cholesterol levels. Although male groups did not differ significantly in disease prevalence, unmarried males had higher total cholesterol, triglyceride levels. In addition, Grade 3 obesity was lower in DINKs and higher in MICW compared to unmarried individuals (DINKs: Exp(B)=1.934, 95% CI 0.417, 8.917; MIWC: Exp(B)=0.449, 95% CI 0.068, 2.990; P = 0.017).

Conclusion: Our findings indicate that DINK females bear a greater metabolic disorder burden and exhibit more adverse anthropometric and laboratory profiles than MIWC and unmarried females, while unmarried males are at increased risk for dyslipidemia and obesity. These results underscore the importance of considering household composition in metabolic risk assessment and tailoring preventive strategies accordingly.