All-cause mortality in metabolically healthy individuals was not predicted by overweight and obesity.

Qiuyue Tian,Shouling Wu,Shuohua Chen,Anxin Wang,Haifeng Hou,Wei Wang,Yingting Zuo,Youxin Wang

doi:10.1172/jci.insight.136982

Qiuyue Tian, Shouling Wu + Show 6 more

Open Access

https://doi.org/10.1172/jci.insight.136982

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Journal: JCI insight	Publication Date: Aug 20, 2020
Citations: 36	License type: CC BY 4.0

Affiliation: North China University of Science and Technology

Abstract

BACKGROUNDMetabolically healthy obesity (MHO) and metabolically healthy overweight (MH-OW) have been suggested to be important and emerging phenotypes with an increased risk of cardiovascular disease (CVD). However, whether MHO and MH-OW are associated with all-cause mortality remains inconsistent.METHODSThe association of MHO and MH-OW and all-cause mortality was determined in a Chinese community-based prospective cohort study (the Kailuan study), including 93,272 adults at baseline. Data were analyzed from 2006 to 2017. Participants were categorized into 6 mutually exclusive groups, according to BMI and metabolic syndrome (MetS) status. The primary outcome was all-cause death, and accidental deaths were excluded.RESULTSDuring a median follow-up of 11.04 years (interquartile range, 10.74–11.22 years), 8977 deaths occurred. Compared with healthy participants with normal BMI (MH-NW), MH-OW participants had the lowest risk of all-cause mortality (multivariate-adjusted HR [aHR], 0.926; 95% CI, 0.861–0.997), whereas there was no increased or decreased risk for MHO (aHR, 1.009; 95% CI, 0.886–1.148). Stratified analyses and sensitivity analyses further validated that there was a nonsignificant association between MHO and all-cause mortality.CONCLUSIONSOverweight and obesity do not predict increased risk of all-cause mortality in metabolic healthy Chinese individuals.FUNDINGNational Natural Science Foundation of China (NSFC; 81673247, 81872682 and 81773527), the NSFC Joint Project, and the Australian National Health and Medical Research Council (NHMRC; NSFC 81561128020-NHMRC APP1112767).

Highlights

Overweight and obesity have become serious public health issue in both developed and developing countries [1, 2]
Compared with healthy participants with normal BMI (MH-NW), metabolically healthy overweight (MH-OW) participants had the lowest risk of all-cause mortality, whereas there was no increased or decreased risk for Metabolically healthy obesity (MHO)
Compared with metabolically healthy normal weight (MH-NW) individuals, Metabolically healthy (MH)-OW and MHO individuals had a history of disease and a higher proportion of older individuals, men, and drinkers

Summary

Introduction

Overweight and obesity have become serious public health issue in both developed and developing countries [1, 2]. Two systematic reviews and meta-analyses, including at least 230 prospective studies, showed that overweight and obesity were associated with increased risk of all-cause mortality [10, 11]; these findings were consistent with a study of 1.46 million White adults [12]. Linear Mendelian randomization analyses have indicated that an increase of 1 unit in genetically predicted BMI gave rise to a 5%–9% increased mortality risk in overweight and obese participants [13]. Healthy obesity (MHO) and metabolically healthy overweight (MHOW) have been suggested to be important and emerging phenotypes with an increased risk of cardiovascular disease (CVD). Whether MHO and MH-OW are associated with all-cause mortality remains inconsistent

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