LAUSR

This study aimed to investigate the gender-specific association between weight misperception and estimated cardiovascular disease (CVD) risk and gender-specific moderation of weight misperception in the associations between obesity indices and CVD risk. In 7836 men and 10,299 women aged 40–79 years without CVD history from the 2014–2018 Korea National Health and Nutrition Examination Survey, the risk of 10-year atherosclerotic cardiovascular disease (ASCVD) was calculated using Pooled Cohort Equations. Weight misperception was defined as accurate estimation, overestimation, or underestimation by comparing perceived weight to actual weight category. Obesity indices were BMI and waist circumference (WC). In fully adjusted models, odds of 10-year ASCVD risk of ≥ 7.5% were lower in men with overestimating weight (odd ratio [95% confidence interval], 0.85 [0.73, 0.99] after adjusting for BMI;0.79 [0.68, 0.92] after adjusting for WC), but higher in women with underestimating weight (1.44 [1.27, 1.63] after adjusting for BMI;1.42 [1.26, 1.61] after adjusting for WC) compared to those with accurate weight estimates. Compared to women with accurate weight estimates, the ASCVD risk associated with obesity indices was higher in those who underestimated weight (ß [95% CI], 0.33 [0.23, 0.43] for BMI;0.16 [0.13, 0.20] for WC), whereas it was lower in those who overestimated weight (−0.15 [−0.28, −0.02] for BMI; −0.07 [−0.11, −0.03] for WC). In men, weight misperception did not moderate the association between obesity indices and the ASCVD risk. These findings suggest that weight misperception was associated with estimated CVD risk independently across gender and moderates the association between obesity indices and estimated CVD risk in women.