Association Between Overweight/Obesity Metabolic Phenotypes Defined by Two Criteria of Metabolic Abnormality and Cardiovascular Diseases: A Cross-Sectional Analysis in a Chinese Population

Abstract

Objectives: Obesity/overweight and metabolic anomalies are known to be associated with elevated cardiovascular disease (CVD) risk. However, there is a paucity of research exploring the association between different body weights, varying metabolic statuses, and the occurrence of CVD in the Chinese population. Thus, we performed this study to explore the relation between different metabolic overweight/obesity phenotypes and the prevalence of CVD.

Methods: We analyzed data from 9075 participants in the Risk Evaluation of cAncers in Chinese diabeTic Individuals: A lONgitudinal (REACTION) study. Participants were classified into four metabolic phenotypes based on their metabolic status and obesity/overweight status. Regression analysis was used to evaluate the relationship between CVD and different groups. Additionally, we conducted a subgroup analysis to further explore the relationship between CVD and different metabolic abnormalities.

Results: Compared to metabolically healthy non-overweight/obesity (MHNO) individuals, both overweight/obesity and metabolic anomalies were positively associated with CVD prevalence. Among other metabolically unhealthy and overweight/obesity phenotypes, metabolically healthy overweight/obesity (MHO) generally exhibited a comparatively lower association with CVD. In the elderly, high waist circumference was significantly associated with CVD, rather than body weight. Further analysis revealed that hypertension had the strongest association with CVD.

Conclusion: Elderly individuals should place more emphasis on managing their waist circumference rather than only on BMI. CVD prevention should focus on both body weight management and treatment of metabolic diseases, with particular emphasis on antihypertensive therapy.

Keywords: cardiovascular disease; metabolic; obesity; phenotype.

Figure 1

Flowchart for selection of study participants. BMI, body mass index; CVD, cardiovascular disease; DBP, diastolic blood pressure; FBG, fasting blood glucose; HDL‐C, high‐density lipoprotein cholesterol; MHNO, metabolically healthy non‐overweight/obesity; MHO, metabolic healthy overweight/obesity; MUNO, metabolically unhealthy non‐overweight/obesity; MUO, metabolic unhealthy overweight/obesity; SBP, systolic blood pressure; TG, triglycerides; WC, waist circumference.