Br J Nutr. 2023 Mar 16:1-21. doi: 10.1017/S0007114523000673. Online ahead of print.
We aimed to investigate the association of metabolic obesity phenotypes with all-cause mortality risk in a rural Chinese population. This prospective cohort study enrolled 15,704 Chinese adults (38.86% men) with a median age of 51.00 (IQR: 41.00-60.00) at baseline (2007-2008) and followed up during 2013-2014. Obesity was defined by waist circumference (WC: ≥90 cm for men and ≥80 cm for women) or waist-to-height ratio (WHtR: ≥0.5). The hazard ratio (HR) and 95% confidence interval (CI) for risk of all-cause mortality related to metabolic obesity phenotypes were calculated using the Cox hazards regression model. During a median follow-up of 6.01 years, 864 deaths were identified. When obesity was defined by WC, the prevalence of participants with metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO), and metabolically unhealthy obesity (MUO) at baseline was 12.12%, 2.80%, 41.93%, and 43.15%, respectively. After adjusting for age, sex, alcohol drinking, smoking, physical activity, and education, the risk of all-cause mortality was higher with both MUNO (HR = 1.20, 95% CI 1.14-1.26) and MUO (HR = 1.20, 95% CI 1.13-1.27) versus MHNO, but the risk was not statistically significant with MHO (HR = 0.99, 95% CI 0.89-1.10), this result remained consistent when stratified by sex. Defining obesity by WHtR gave similar results. MHO does not suggest a greater risk of all-cause mortality compared to MHNO, but participants with metabolic abnormality, with or without obesity, have a higher risk of all-cause mortality. These results should be cautiously interpreted as the representation of MHO is small.
PMID:36924137 | DOI:10.1017/S0007114523000673