Document Type

Journal Article

Publication Title

JCI insight





PubMed ID



The American Society for Clinical Investigation


School of Medical and Health Sciences


Tian, Q., Wang, A., Zuo, Y., Chen, S., Hou, H., Wang, W., ... & Wang, Y. (2020). All-cause mortality in metabolically healthy individuals was not predicted by overweight and obesity. JCI insight, 5(16).


BACKGROUND Metabolically 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.METHODS The 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.RESULTS During 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.CONCLUSIONS Overweight 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).



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This work is licensed under a Creative Commons Attribution 4.0 License.