Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Roles of general and central adiposity in cardiometabolic multimorbidity: revisiting the obesity paradox using a multistate model
First author：Xue Xia
Corresponding author：Anxin Wang
essential_information
- Person in charge：Xue Xia
- Data Sources： Kailuan Study
- Number of papers：KAILUAN STUDY20240031
- Published time：2024-01-28
2024-01-28
Published articles
Journal：Obesity
Publication type: Original Contributions
IF(IF): 6.9
PMID: 38282432 Link To Pubmed Full text Download
Background And Purpose
The objective of this study was to evaluate the associations of general and central obesity with risk of first cardiometabolic disease (FCMD), cardiometabolic multimorbidity (CMM), and death.
Method
A total of 86,169 participants who were CMD-free were included from the Kailuan cohort and categorized into four groups by quartiles of BMI, waist to hip ratio (WHR), weight-adjusted waist index, and waist to height ratio. We defined FCMD as the first onset of diabetes, stroke, or myocardial infarction and CMM as co-occurrence of at least two CMDs. Multistate models were used to estimate hazard ratios and 95% CI.
Conclusion
Central adiposity indices such as WHR were associated with an increased risk of CMD and mortality, showing no evidence for the obesity paradox and thereby supporting a shift of public focus from BMI only to both general obesity and adiposity distribution.
Main results
A total of 18,461 participants developed FCMD, of whom 1476 progressed to CMM, and 10,009 died during follow-ups. Both general and central adiposity indices increased the risk of transition from baseline to FCMD and from FCMD to CMM. However, compared with the first quartile, the hazard ratio (95% CI) of the fourth quartile of BMI was 0.86 (95% CI: 0.80-0.91) for transition from health to death and 0.66 (95% CI: 0.59-0.74) from FCMD to death, whereas the corresponding estimates of WHR were 1.22 (95% CI: 1.14-1.31) and 1.16 (95% CI: 1.02-1.32), respectively.