Introduction
Methods
Study design and participants
Inclusion and exclusion criteria
Data collection and measurement
Definitions of metabolic status and body weight
Definition of CAP
Covariates
Statistical analysis
Results
Baseline characteristics
Variable | Median (p25, p75) or percentage (%) | P value | |||||
---|---|---|---|---|---|---|---|
Total
|
MHNO
|
MHO
|
MUNO
|
MUO
| |||
N = 8,645
|
N = 2,257
|
N = 80
|
N = 5,360
|
N = 948
| |||
Sociodemographics
| |||||||
Age, year
| 44 | 32 | 29 | 45 | 44 | < 0.001 | |
(29.00, 48.00) | (25.00, 45.00) | (24.00, 43.00) | (38.00, 49.00) | (33.75, 48.00) | |||
Age subgroup
| < 0.001 | ||||||
<45 years | 4,716 (54.55) | 1,640 (72.66) | 61 (76.25) | 2,489 (46.44) | 526 (55.49) | ||
≥ 45 years | 3,929 (45.45) | 617 (27.34) | 19 (23.75) | 2,871 (53.56) | 422 (44.51) | ||
Medical history
| |||||||
Diabetes | 404 (4.67) | 0 (0.00) | 0 (0.00) | 345 (6.44) | 59 (6.22) | < 0.001 | |
Hypertension | 1,071 (12.39) | 0 (0.00) | 0 (0.00) | 801 (14.94) | 270 (28.48) | < 0.001 | |
Hyperlipidemia | 316 (3.66) | 0 (0.00) | 0 (0.00) | 231 (4.30) | 85 (8.97) | < 0.001 | |
CVD | 76 (0.88) | 13 (0.58) | 0 (0.00) | 52 (0.97) | 11 (1.16) | < 0.001 | |
Lifestyle behaviors
| |||||||
Current smoker | 5,404 (62.51) | 1,257 (55.69) | 49 (61.25) | 3,474 (64.81) | 624 (65.82) | < 0.001 | |
Current drinker | 1,420 (16.41) | 194 (8.60) | 10 (12.25) | 1,039 (19.38) | 177 (18.67) | < 0.001 | |
Circadian rhythm disorders | 4,929 (57.02) | 1,334 (59.11) | 46 (57.50) | 2,975 (55.50) | 574 (60.55) | < 0.001 | |
Clinical variables
| |||||||
BMI, kg/m2 | 24.04 | 22.03 | 29.37 | 24.13 | 29.46 | < 0.001 | |
(21.99, 26.26) | (20.10, 23.95) | (28.58, 30.30) | (22.46, 25.79) | (28.68, 30.74) | |||
BMI < 28 kg/m2 | 7,617 (88.11) | 2,257 (1.00) | 0 (0.00) | 5,360 (1.00) | 0 (0.00) | < 0.001 | |
28 ≤ BMI < 30 kg/m2 | 625 (7.23) | 0 (0.00) | 52 (65.00) | 0 (0.00) | 573 (60.44) | < 0.001 | |
BMI ≥ 30 kg/m2 | 403 (4.66) | 0 (0.00) | 28 (35.00) | 0 (0.00) | 375 (39.56) | < 0.001 | |
SBP, mmHg | 124 | 114 | 118 | 128 | 132 | < 0.001 | |
(114.00, 134.00) | (107.00, 120.00) | (112.75, 124.25) | (119.00, 137.00) | (124.00, 140.00) | |||
DBP, mmHg | 81 | 73 | 75.5 | 85 | 88 | < 0.001 | |
(74.00, 89.00) | (68.00, 78.00) | (70.75, 80.00) | (77.00, 91.00) | (81.00, 95.00) | |||
TC, mmol/L | 4.65 | 4.27 | 4.43 | 4.77 | 4.87 | < 0.001 | |
(4.08, 5.24) | (3.79, 4.80) | (3.95, 4.91) | (4.21, 5.38) | (4.33, 5.48) | |||
TG, mmol/L | 1.59 | 1.06 | 1.31 | 1.9 | 2.3 | < 0.001 | |
(1.10, 2.38) | (0.83, 1.30) | (1.15, 1.52) | (1.32, 2.65) | (1.67, 3.22) | |||
HDL-C, mmol/L | 1.34 | 1.46 | 1.35 | 1.31 | 1.23 | < 0.001 | |
(1.17, 1.54) | (1.31, 1.67) | (1.23, 1.50) | (1.13, 1.51) | (1.06, 1.38) | |||
LDL-C, mmol/L | 2.89 | 2.53 | 2.78 | 2.98 | 3.15 | < 0.001 | |
(2.41, 3.38) | (2.14, 2.97) | (2.48, 3.16) | (2.52, 3.48) | (2.74, 3.61) | |||
FBG, mmol/L | 5.2 | 4.95 | 4.96 | 5.33 | 5.43 | < 0.001 | |
(4.86, 5.63) | (4.68, 5.20) | (4.80, 5.22) | (4.95, 5.79) | (5.04, 6.01) | |||
SUA, mmol/L | 387 | 367 | 438 | 389 | 434 | < 0.001 | |
(337.00, 447.00) | (325.00, 419.00) | (381.00, 488.00) | (340.00, 447.00) | (374.00, 496.25) | |||
Metabolic risk components
| |||||||
Elevated BP | 4,021 (46.51) | 0 (0.00) | 0 (0.00) | 3,334 (62.20) | 687 (72.47) | < 0.001 | |
Elevated FBG | 2,301 (26.62) | 0 (0.00) | 0 (0.00) | 1,894 (35.34) | 407 (42.93) | < 0.001 | |
Elevated TG | 3,969 (45.91) | 0 (0.00) | 0 (0.00) | 3,273 (61.06) | 696 (73.42) | < 0.001 | |
Reduced HDL-C | 1,016 (11.75) | 0 (0.00) | 0 (0.00) | 816 (15.22) | 200 (21.10) | < 0.001 | |
Number of abnormal metabolisms
| < 0.001 | ||||||
1 | 2,702 (31.26) | 0 (0.00) | 0 (0.00) | 2,451 (45.73) | 251 (26.48) | ||
2 | 2,237 (25.88) | 0 (0.00) | 0 (0.00) | 1,867 (34.83) | 370 (39.03) | ||
3 | 1,170 (13.53) | 0 (0.00) | 0 (0.00) | 899 (16.77) | 271 (28.59) | ||
4 | 199 (2.30) | 0 (0.00) | 0 (0.00) | 143 (2.67) | 56 (5.91) | ||
Outcome variables
| |||||||
CAP | 1,260 (14.57) | 121 (5.36) | 7 (8.75) | 955 (17.82) | 177 (18.67) | < 0.001 |
Association between CAP and metabolic obese phenotypes
OR(95%CI) | ||||
---|---|---|---|---|
Crude model
| P-value |
Adjusted model
a
| P-value | |
MHNO
| 1.00 (ref.) | 1.00 (ref.) | ||
MHO
| 1.69 (0.70, 3.51) | 0.2 | 2.18 (0.82, 5.10) | 0.09 |
MUNO
| 3.83 (3.16, 4.68) | < 0.001 | 1.78 (1.44, 2.21) | < 0.001 |
MUO
| 4.05 (3.17, 5.19) | < 0.001 | 2.20 (1.67, 2.89) | < 0.001 |
OR(95%CI) | ||||
---|---|---|---|---|
Crude model
| P-value |
Adjusted model
a
| P-value | |
BMI
| 1.07 (1.05, 1.09) | < 0.002 | 1.04 (1.02, 1.06) | < 0.001 |
SBP
| 1.05 (1.04, 1.05) | < 0.001 | 1.03 (1.02, 1.03) | < 0.001 |
DBP
| 1.06 (1.05, 1.07) | < 0.001 | 1.04 (1.03, 1.04) | < 0.001 |
FBG
| 1.29 (1.25, 1.34) | < 0.001 | 1.14 (1.09, 1.18) | < 0.001 |
TG
| 1.10 (1.07, 1.13) | < 0.001 | 1.02 (0.99, 1.06) | 0.22 |
HDL-C
| 1.10 (0.91, 1.33) | 0.34 | 0.84 (0.68, 1.05) | 0.13 |
Subgroup analysis
Sensitivity analysis
Obesity with Asia Pacific criteria | Obesity with WHO criteria | |||||||
---|---|---|---|---|---|---|---|---|
OR (95%CI)
a
|
OR (95%CI)
a
| |||||||
Crude model
|
P
-value
|
Adjusted model
a
|
P
-value
|
Crude model
|
P
-value
|
Adjusted model
a
|
P
-value
| |
MHNO
| 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | ||||
MHO
| 1.61 (1.04, 2.42) | < 0.05 | 1.21 (0.76, 1.88) | 0.42 | 2.11 (0.50, 6.13) | 0.23 | 2.10 (0.49, 6.08) | 0.23 |
MUNO
| 3.86 (3.10, 4.85) | < 0.001 | 1.72 (1.36, 2.20) | < 0.001 | 3.88 (3.21, 4.72) | < 0.001 | 3.85 (3.19, 4.68) | < 0.001 |
MUO
| 4.50 (3.62, 5.66) | < 0.001 | 2.02 (1.58, 2.60) | < 0.001 | 3.42 (2.45, 4.73) | < 0.001 | 3.39 (2.43, 4.69) | < 0.001 |