All-cause mortality in metabolically healthy individuals was not predicted by overweight and obesity

BACKGROUND. Metabolically healthy obesity (MHO) and metabolically healthy overweight (MHOW) have been suggested to be important and emerging phenotypes with an increased risk of cardiovascular disease (CVD). However, whether MHO and MH-OW are associated with all-cause mortality remains inconsistent. METHODS. The association of MHO and MH-OW and all-cause mortality was determined in a Chinese community-based prospective cohort study (the Kailuan study), including 93,272 adults at baseline. Data were analyzed from 2006 to 2017. Participants were categorized into 6 mutually exclusive groups, according to BMI and metabolic syndrome (MetS) status. The primary outcome was all-cause death, and accidental deaths were excluded. RESULTS. During a median follow-up of 11.04 years (interquartile range, 10.74-11.22 years), 8977 deaths occurred. Compared with healthy participants with normal BMI (MH-NW), MH-OW participants had the lowest risk of all-cause mortality (multivariate-adjusted HR [aHR], 0.926; 95% CI, 0.861-0.997), whereas there was no increased or decreased risk for MHO (aHR, 1.009; 95% CI, 0.886-1.148). Stratified analyses and sensitivity analyses further validated that there was a nonsignificant association between MHO and all-cause mortality. CONCLUSIONS. Overweight and obesity do not predict increased risk of all-cause mortality in metabolic healthy Chinese individuals.