Study On The Relationship Between Metabolically Healthy Obesity And All-cause Death And Cardiovascular Death In Northeast Rural Areas

Objective:Obesity has become one of the major health problems in the global epidemic.Obesity has influences on health in many aspects and has multiple harms.Among obese patients,a phenotype called metabolically healthy obesity has attracted the attention of researchers,many of whom have focused on the relationship between MHO and population mortality.However,according to the results of different studies,the relationship between MHO and the risk of all-cause mortality and CVD mortality is controversial,and different studies use different definitions of MHO.Domestic research on MHO is relatively limited,and there is a lack of research on the relationship between MHO and population mortality in Northeast China.Therefore,resident residents in rural areas of northeast China were selected in this study,and three different MHO definitions used in current domestic and foreign studies were applied to classify the population to explore the relationship between MHO and all-cause mortality and cardiovascular death.Then evaluate three different definitions to provide evidence for relevant domestic studies.Methods:In this study,stratified cluster random sampling method was adopted to select the permanent residents aged 35 years and above in rural areas of Liaoning Province.Basic information questionnaire,physical examination and serological examination were conducted for the subjects meeting the requirements,and follow-up was conducted to collect the death information.The Asia Pacific regional criteria formulated by WHO was used for the diagnosis of obesity.The diagnosis of metabolic syndrome was based on the modified ATP-Ⅲstandard in 2005,IDF standard in 2005and the joint interim statement in 2009,and the population was divided into four groups:MHN,MHO,MUN and MUO.SPSS26 statistical software was used for data processing and analysis.Continuous data was expressed as mean±standard deviation,and enumeration data was expressed as frequency and component ratio.χ~2 test and t test were used to evaluate the distribution differences of the factors among the population.Kaplan-Meier curves were plotted using Graph Pad Prism 6,survival curves were compared using Log-rank test,and the association between MHO and death was estimated by Cox survival analysis.P<0.05 was considered statistically significant.Results:A total of 9037 subjects were included in this study.During a mean follow-up period of 4.58 years,a total of 416 deaths occurred,208 of which were CVD deaths,with mortality rates of 4.6%and 2.3%,respectively.With the MHN group used as reference,after adjusting for factors,the risk of CVD mortality was higher in the MUN group[HR=1.73,95%CI(1.16-2.58)]and the MUO group[HR=1.59,95%CI(1.13-2.23)]under the modified ATPⅢcriteria.Under IDF criteria,the MUO group[HR=1.42,95%CI(1.01-1.99)]had an increased risk of CVD mortality.Under the harmonized definition,the risk of all-cause mortality[HR=1.38,95%CI(1.04-1.83)]and the risk of death from CVD[HR=1.71,95%CI(1.15-2.52)]were both increased in the MUN group,and the risk of all-cause mortality[HR=1.29,95%CI(1.02-1.63)]and the risk of death from CVD[HR=1.64,95%CI(1.18-2.29)]were increased in the MUO group.The MHO group had no increased risk of all-cause mortality or CVD mortality using any criteria.Conclusions:In rural areas of northeast China,the prevalence of MHO is 18.1-22.0%.The risk of all-cause mortality and CVD mortality in MHO population did not increase compared with MHN population,and the JIS standard is more suitable for MHO identification in northeast China.The warning effect of MHO on metabolic health is still worthy of attention.Taking measures against metabolic health risk factors will help reduce the health burden caused by obesity and Mets.