Risk of arterial stiffness according to metabolically healthy obese phenotype: a combined cross-sectional and longitudinal study in kailuan cohort

Abstract

BackgroundTo investigate the risk of incident arterial stiffness according to metabolically healthy obese (MHO) phenotype in Chinese population. Materials and methodsThe Kailuan study is an ongoing prospective cohort study, 37,180 participants with at least one-time measurement of branchial-ankle pulse wave velocity (baPWV) were included in the cross-sectional analysis, and 16,236 participants with repeated measurement of baPWV during the follow-ups were included in the longitudinal study from March 1, 2010, to January 31, 2020. Cross-classi cation of body mass index (BMI) categories and metabolic health status created six groups. Linear and logistic regression analyses were used to assess the association between BMI-metabolic status phenotypes and baPWV in mono-factor and multi-factor models. ResultsThe results of cross-sectional and longitudinal investigation were basically the same, as the abnormality of baPWV increased with BMI categories in metabolically healthy participants, while the increasing tendency disappeared in metabolically unhealthy participants. A 1.6-fold, 2.8-fold increased risk for the new occurrence of arterial stiffness were documented in MHO and metabolically unhealthy obese participants compared to metabolically healthy normal weight controls in the fully adjusted model. Further strati ed analysis shown that metabolic health status was an interaction factor between BMI and arterial stiffness in either study population (P<0.0001 for cross-sectional study and P=0.0003 for longitudinal study). ConclusionsMetabolic health status and BMI categories contribute to the progression of arterial stiffness, while BMI is positively associated with arterial stiffness only in metabolically healthy participants. Moreover, MHO is an intermediate stage between metabolically healthy and unhealthy status.

Association of metabolically unhealthy non-obese and metabolically healthy obese individuals with arterial stiffness and 10-year cardiovascular disease risk: a cross-sectional study in Chinese adults

“…In addition, the study population was smaller than the present study [ 15 ]. Our study, which was conducted among a relatively high number of Chinese adults and adopted a reasonable cutoff value of elevated baPWV, showed that participants with MUNO had a significantly higher baPWV and odds ratio of elevated baPWV than participants with MHNO and MHO, consistent with previous studies [ 22 , 23 ]. In addition, the Framingham risk score was used to assess the 10-year CVD risk in MUNO individuals.…”

“…Because there is no definite cutoff value for elevated baPWV and the cutoff value is different between male and female populations, it is reasonable to define the sex-specific upper quartile of baPWV of the study population as the cutoff value of elevated baPWV. To the best of our knowledge, three studies investigated the relationship between MUNO and baPWV in a Chinese population, but the cutoff value of elevated baPWV was robust in two of the three studies [ 22 , 23 ]. In addition, the study population was smaller than the present study [ 15 ].…”

“…A prospective study including 6220 Chinese adults indicated that there was no relationship between baseline MHO and the incidence of subclinical atherosclerosis. However, those who transitioned to MHO had an increased subclinical atherosclerosis risk [23]. A prospective cohort study in a general Chinese population showed that even maintaining the MHO phenotype over time was correlated with a higher CVD risk [29].…”

Association between dietary quality and accelerated aging: a cross-sectional study of two cohorts

“…The Kailuan Study is a population-based prospective cohort study that includes current and retired employees of the Kailuan Group. 20 NHANES is a comprehensive U.S. public database that evaluates the health and nutritional statuses of American adults and children, serving as a resource for epidemiological and health-related research. Participants from both cohorts were asked to complete a detailed questionnaire including demographic and sociological information, as well as data on lifestyle habits and dietary intake.…”