Comparison of the Incidence of Cardiovascular Diseases in Weight Groups with Healthy and Unhealthy Metabolism

BACKGROUND: We aimed to identify the relationship between metabolically healthy obesity (MHO), a special subtype of obesity, and the incidence of cardiovascular disease (CVD) in rural Xinjiang. METHODS: Body mass index (BMI) and the Joint Interim Statement criteria were utilized to define obesity and metabolic status, respectively. A baseline survey was conducted between 2010 and 2012. The cohort was followed-up until 2017, including 5059 participants (2953 Uyghurs and 2106 Kazakhs) in the analysis. RESULTS: During 6.78 years of follow-up, 471 individuals developed CVD, 10.8% (n=545) of whom were obese, and the prevalence of MHO and MHNW was 5.2% and 54.5%, respectively. Compared with metabolically healthy normal weight subjects, the subjects with MHO had an increased risk of CVD (hazard ratio [HR]=1.76, 95% confidence interval [CI]: 1.23−2.51), while the metabolically unhealthy obesity (MUO) group had an even higher risk (HR=3.80, 95% CI: 2.87−5.03). Additionally, there were sex differences in the relationship between BMI-metabolic status and incident CVD (P(interaction) =0.027). Compared with the subjects with MHO, those with MUO had an increased risk of CVD (HR=1.84, 95% CI: 1.26−2.71). CONCLUSION: MHO was associated with a high risk of CVD among adults in rural Xinjiang. In each BMI category, metabolically unhealthy subjects had a higher risk of developing CVD than did metabolically healthy subjects.