Key result
Being metabolically unhealthy according to a new definition was not significantly associated with increased all-cause mortality in nonobese Chinese adults (adjusted HR 1.42).
Why the study?
A new metabolic health definition developed from NHANES-III stratifies mortality risks in overweight or normal-weight individuals, but its association with all-cause mortality in a nonobese Chinese population required investigation.
Does a newly defined metabolically unhealthy status predict all-cause mortality in a nonobese Chinese population?
Cohort (n=1,157)
No
Does a newly defined metabolically unhealthy status predict all-cause mortality in a nonobese Chinese population?
Hazard Ratio: 1.42 (95% CI 0.49–4.17)
Absolute Event Rate: 5.49% vs 1.85%
p-value: p=0.519
A newly proposed metabolic health definition did not reliably stratify all-cause mortality risk in a nonobese Chinese cohort after adjusting for confounders.
New MH definition may not predict mortality in nonobese Chinese adults; leaves open validation in other groups before risk stratification use.
BACKGROUND: Recently, a new metabolic health (MH) definition was developed from NHANES-III. In the origin study, the definition may stratify mortality risks in people who are overweight or normal weight. We aimed to investigate the association between the new MH definition and all-cause mortality in a nonobese Chinese population. METHODS: The data were collected in 1992 and then again in 2007 from the same group of 1157 participants. The association between the new MH definition and all-cause mortality were analyzed by Cox regression models with overlap weighting according to propensity score (PS) as primary analysis. RESULTS: At baseline in 1992, 920 (79.5%) participants were categorized as MH, and 237 (20.5%) participants were categorized as metabolically unhealthy (MUH) based on this new definition. During a median follow-up of 15 years, all-cause mortality occurred in 17 (1.85%) participants in MH group and 13 (5.49%) in MUH group, respectively. In the crude sample, Kaplan-Meier analysis demonstrated a significantly higher all-cause mortality in MUH group when compared to MH group (log-rank p = 0.002), and MUH was significantly associated with increased all-cause mortality when compared to MH with HR at 3.04 (95% CI: 1.47-6.25, p = 0.003). However, Kaplan-Meier analysis with overlap weighting showed that the cumulative incidence of all-cause mortality was not significantly different between MH and MUH groups (adjusted p = 0.589). Furthermore, in the primary multivariable Cox analysis with overlap weighting, adjusted HR for all-cause mortality was 1.42 (95% CI: 0.49-4.17, p = 0.519) in MUH group in reference to MH group. Other additional PS analyses also showed the incidence of all-cause mortality was not significantly different between the two groups. CONCLUSION: The new MH definition may be not appropriate for mortality risk stratification in non-obese Chinese people. Further investigations are needed.
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Wang et al. (2022) conducted a cohort in Nonobese (n=1,157). Metabolically unhealthy (MUH) status by new definition vs. Metabolically healthy (MH) status was evaluated on All-cause mortality (HR 1.42, 95% CI 0.49-4.17, p=0.519). Being metabolically unhealthy according to a new definition was not significantly associated with increased all-cause mortality in nonobese Chinese adults (adjusted HR 1.42).
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