Metabolically healthy obese phenotype and risk of cardiovascular disease: Results from the China Health and Retirement Longitudinal Study

Document Type

Journal Article

Publication Title

Archives of Gerontology and Geriatrics


Elsevier Ireland Ltd


School of Medical and Health Sciences




Li, H., He, D., Zheng, D., Amsalu, E., Wang, A., Tao, L., . . . Guo, X. (2019). Metabolically healthy obese phenotype and risk of cardiovascular disease: Results from the china health and retirement longitudinal study. Archives of Gerontology and Geriatrics, 82, 1-7. Available here


Background: Epidemiologic evidence on metabolically healthy obese (MHO) phenotype and cardiovascular diseases (CVD) risk remains controversial. Aims: We aim to examine the relationship between MHO and risk of CVD among the Chinese population. Methods: The China Health and Retirement Longitudinal Study is a prospective cohort study of 7849 participants aged ≥45 years without CVD at baseline. Metabolic health status was assessed based on blood pressure, triglycerides, high-density lipoprotein cholesterol, glycated hemoglobin, fasting glucose, and C-reactive protein. A cutoff point of body mass index of 24.0 kg/m 2 was used to define over-weight/obesity (≥24.0 kg/m 2 ) or normal weight (<24.0 kg/m 2 ). CVD was based on self-reported doctor's diagnosis of heart problems and stroke. Incidence rate ratio (IRR) with 95% confidence interval (CI) was deduced from modified Poisson regression. Results: During a mean 3.6 years of follow-up, 880 incident CVD events were recorded. 789 (10.05%) were identified MHO among 3321 (42.3%) obese individuals. Compared with metabolically healthy normal weight individuals, the multivariable adjusted IRR of CVD was 1.33 (95%CI: 1.19–1.49) for MHO, 1.29 (95%CI: 1.22–1.38) for metabolically unhealthy normal weight, and 1.61 (95%CI: 1.51–1.75) for metabolically unhealthy obese in the full adjusted model. Conclusions: MHO individuals are associated with the increased risk of cardiovascular diseases among the Chinese population. © 2019 Elsevier B.V.



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