Key result
Metabolically unhealthy obesity is linked to a ~5-fold higher risk of incident cardio-renal-metabolic multimorbidity.
Why the study?
Do metabolically unhealthy or overweight/obese phenotypes increase the risk of incident cardio-renal-metabolic multimorbidity in adults?
Cohort (n=6,407)
Do metabolically unhealthy or overweight/obese phenotypes increase the risk of incident cardio-renal-metabolic multimorbidity in adults?
Hazard Ratio: 4.89 (95% CI 3.59–6.65)
Absolute Event Rate: 33.8% vs 6.2%
Any deviation from a metabolically healthy normal weight phenotype significantly increases the long-term risk of developing cardio-renal-metabolic multimorbidity.
Background/Introduction The associations between metabolic phenotypes of obesity and non-communicable diseases (NCDs) are widely reported; however, less is known regarding these associations according to the cardio-renal-metabolic (CRM) multimorbidity, defined as having ≥ 2 NCDs including diabetes, hypertension, chronic kidney disease, cardiovascular disease, and cancer. Purpose We aimed to evaluate the association between metabolic phenotypes of both general and central obesity with incident CRM multimorbidity during about two decades of follow-up among adults aged ≥20 years Methods Among 6,407 participants (3,588 women), with a mean age of 37.10 years, metabolically healthy status was defined as the absence of any metabolic syndrome components. Metabolic obesity phenotypes were classified as metabolically healthy/unhealthy normal weight (MHNW/MUNW), overweight (MHOW/MUOW), and obese (MHO/MUO) based on BMI levels; and metabolically healthy/unhealthy non-abdominal obese (MHNAO/MUNAO) and abdominal obese (MHAO/MUAO) according to waist circumference. Multivariable Cox proportional hazards regression models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results During a median follow-up of 14.3 years, CRM multimorbidity occurred in 6.2, 15.2, 18.0, 13.1, 20.9, and 33.8% of participants with MHNW, MHOW, MHO, MUNW, MUOW, and MUO phenotypes, respectively. Compared to the MHNW phenotype, participants with MHOW [HR (95% CI); 1.95 (1.32-2.88)], MHO [2.18 (1.26-3.76)], MUNW [2.14 (1.57-2.93)], MUOW [2.80 (2.07-3.79)], and MUO [4.89 (3.59-6.65)] phenotypes had higher risk of developing CRM multimorbidity. Furthermore, compared to the MHNAO phenotype, participants with MHAO [1.74 (1.21-2.51)], MUNAO [1.91 (1.49-2.46)], and MUAO [3.21 (2.51-4.11)] also exhibited elevated risk. Generally, we found no effect modification by sex and age; however, the impacts of these phenotypes were more prominent among women and younger population. Conclusion Only keeping normal weight, without having any metabolic syndrome components, might prevent incident CRM multimorbidity
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Molavizadeh et al. (2025) conducted a cohort in Cardio-renal-metabolic (CRM) multimorbidity (n=6,407). Metabolically unhealthy obesity (MUO) vs. Metabolically healthy normal weight (MHNW) was evaluated on Incident CRM multimorbidity (HR 4.89, 95% CI 3.59-6.65). Metabolically unhealthy obesity was associated with a higher risk of incident cardio-renal-metabolic multimorbidity compared to metabolically healthy normal weight (HR 4.89; 95% CI 3.59-6.65).
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