| Objective:In this study,the ethnic population in rural areas of Xinjiang was selected as the research subject.The baseline data of cohort study was used to describe the prevalence of metabolically healthy obesity（MHO）in rural areas of Xinjiang,and the influencing factors of MHO were screened by Logistic regression model.The incidence of cardiovascular disease（CVD）in 5 years was prospectively observed.Cox regression was used to explore the relationship between MHO and the risk of CVD.It is of great significance for the precise intervention of obese people in rural areas of Xinjiang and the prevention and treatment of CVD.Methods:A four stage cluster random sampling method was adopted to select 6 villages in Nalati Town,Xinyuan County,Yili,Xinjiang,and 12 brigades in Jiangbazi Township,Jiashi County,Kashi as the research sites.The baseline survey was from 2010 to 2012,during which a total of 6736 subjects were surveyed.The study site was followed up three times in 2013,2016 and 2017,and a total of 6053 study subjects were followed up,with a follow-up rate of 89.9%.A total of 5059 subjects were finally included for analysis,and the median follow-up time was 6.78 years.ANOVA and Chi-square test were used to compare the baseline information of the subjects.Binary Logistic regression was used to analyze the influencing factors of MHO,including demographic characteristics,lifestyle and dietary habits.Cox regression was used to analyze the relationship between BMI category,metabolic status,number of metabolic abnormalities and 6 phenotypes and the risk of CVD.Stratified analysis was used to investigate whether the risk of CVD varied with gender,age,and educational level.The interaction analysis was carried out,and the interaction term was the product of the stratified variable and the independent variable.Sensitivity analysis was used to investigate whether the above 6 phenotypes and the risk of CVD would change with different metabolic diagnostic criteria.Results:1.The prevalence of MHO in Xinjiang rural ethnic population was 4.8%,and the prevalence of MHO in obese people was 47.3%.2.Blood pressure,low density lipoprotein cholesterol,total cholesterol,BMI and waist circumstance（WC）levels in MHO group were higher than those in metabolically healthy normal weight（MHNW）group（P<0.001）.3.In obese people,the prevalence of MHO decreased with increasing age,BMI and waist circumference(P trend<0.001).4.Univariate and multivariate Logistic regression showed that increased age,meat intake≥2 kg/week and increased WC were negatively correlated with normal metabolism,while vegetable intake≥4 plates/week was positively correlated with normal metabolism.5.Univariate and multivariate Cox regression showed that overweight,obesity and metabolic abnormalities increased the risk of CVD.With the increase of metabolic abnormalities,the risk of CVD gradually increased.6.Multivariate Cox regression analysis showed that the other five subtypes increased the risk of CVD compared with MHNW group.The risk of CVD was 1.75 times higher in the MHO group than in the MHNW group（HR=1.75,95%CI:1.21-2.53）,metabolically unhealthy obesity（MUO）group has the highest risk of CVD（HR=4.04,95%CI:3.04-5.38）.7.Stratified analysis showed that the risk of CVD was similar among the 6 phenotypes in different sex,age and education level groups(P interaction>0.05).8.Sensitivity analysis showed that the relationship between the 6 phenotypes and the risk of CVD did not change with different metabolic diagnostic criteria.Conclusions:1.The prevalence of MHO in rural Xinjiang population and the prevalence of MHO in obese population are higher than those in domestic Han population.2.Increasing age,eating more meat and larger waist circumference increases the risk of metabolic abnormalities,while eating more vegetables decreases the risk of metabolic abnormalities.3.Compared with MHNW group,MHO increased the risk of CVD,and MUO group was higher. |
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