Relationship between obesity phenotypes and cardiovascular risk in a Chinese cohort

Yueliang Hu, Shuping Zheng, Jiehui Zhao, Isabella Tan, Mark Butlin, Alberto Avolio, Junli Zuo*

*Corresponding author for this work

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Objective: The changing living patterns in China are accompanied by an increase in prevalence of cardiovascular disease for which obesity is a significant factor. This study investigated the association between obesity phenotypes and risk of cardiovascular disease in a Chinese cohort. Methods: A sample of 10,826 community-dwelling individuals aged 40–79 years (mean age 62.2 ± 12.0 years) were stratified by categories of body mass index (BMI) (normal weight: BMI < 24 kg/m2; overweight: BMI of 25–28 kg/m2; obese: BMI > 28 kg/m2) and metabolic status and divided into six phenotypes: (1) normal metabolic status and normal weight; (2) normal metabolic status and overweight; (3) normal metabolic status and obese; (4) normal weight and dysmetabolic status; (5) dysmetabolic status and overweight; (6) dysmetabolic status and obese. The Atherosclerotic Cardiovascular Disease (ASCVD) risk score was determined based on cardiovascular risk factors. Results: Prevalence of overweight and obesity was 15.2% and 25.2% respectively. After adjusting for confounding factors, ASCVD score was significantly higher in men [Odds Ratio (OR): 9.796, 95% confidence interval (CI): 5.833–16.450; p < 0.001] and women [OR: 5.821, 95% CI: 4.253–7.968; p < 0.001] with obese and dysmetabolic status compared to normal. The odds of reporting ASCVD risk was significantly higher in men (OR: 3.432, 95% CI: 1.965–5.996; p < 0.001) and women (OR: 4.647, 95% CI: 3.327–6.491; p < 0.001) with obese and dysmetabolic status compared to those with obese and normal metabolic status. In addition, the odds of reporting ASCVD risk was significantly lower in men (OR: 0.317, 95% CI: 0.142–0.707; p = 0.005) and women (OR: 0.487, 95% CI: 0.320–0.739; p = 0.001) with the overweight–dysmetabolic status phenotype compared to those with an overweight–normal metabolic phenotype. Conclusion: Obese dysmetabolic individuals had the highest ASCVD risk score in all phenotypes. When BMI category was overweight, BMI played a more important role than metabolic status, whereas when BMI category was obesity, risk was more affected by metabolic status.

Original languageEnglish
Pages (from-to)34-41
Number of pages8
JournalArtery Research
Issue number1
Publication statusPublished - 1 Mar 2020

Bibliographical note

Copyright Association for Research into Arterial Structure and Physiology 2020. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • Body mass index
  • Cardiovascular risk
  • Metabolic syndrome
  • Obesity


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