Factors Associated with Waist Circumference Categories and Metabolic Risks Among Korean Adults: a cross-sectional survey based on the 2023 Korea National Health and Nutrition Survey

Background This study aimed to identify factors associated with waist circumference categories among Korean adults with metabolic disorders, providing foundational data to support the prevention and management of metabolic syndrome. Methods Data from the 9th Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. Complex sample chi-square tests and complex sample multiple logistic regression analyses were employed to examine relationships between waist circumference categories and various sociodemographic and health-related factors. Results Participants with underweight or normal body mass index (BMI) were 225.381 times more likely to fall within the normal waist circumference group compared to the high-risk group (95% CI: 143.034–355.135, p < 0.001). Non-diabetic individuals had 2.796 times higher odds (95% CI: 1.500–5.211, p = 0.001), and those not taking oral hypoglycemic agents had 1.843 times higher odds (95% CI: 1.338–2.540, p < 0.001). Furthermore, individuals who consumed alcohol at least twice per week (OR = 2.569, 95% CI: 1.527–4.322, p < 0.001) and current smokers (OR = 1.846, 95% CI: 1.150–2.964, p = 0.011) were more likely to be in the normal waist circumference group. Conclusion BMI, diabetes status, medication use, alcohol consumption, and smoking were identified as significant factors influencing waist circumference regulation. These findings may inform the development of targeted, behavior-based interventions aimed at reducing metabolic risk among adults.