Relationship between Obesity Phenotypes and Cardiovascular Risk in a Chinese Cohort

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/m 2 ; overweight: BMI of 25–28 kg/m 2 ; obese: BMI > 28 kg/m 2 ) 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.