Longitudinal Associations of Changes in Body Mass Index and Waist‐to‐Height Ratio With Cardiometabolic Risk Factors: Sex‐Specific Analyses in UK Biobank
Authors' conclusion
Adiposity reduction was associated with favourable cardiometabolic profiles, whereas gain was associated with adverse profiles. BMI and WHtR showed broadly similar directions and patterns of association, with some variation by outcome and sex. These observational associations support prevention of excess adiposity gain and sustained adiposity reduction where clinically appropriate.
Study context
- Population
- UK Biobank participants with repeated anthropometric and biochemical measurements, excluding those with baseline cardiovascular disease, renal failure or cancer; mean baseline body mass index (BMI) 26.8 kg/m² (SD: 4.5)participants analysed
- Participants
- 16,911 participants
- Exposure
- ≥ 10% BMI loss or gain compared with stable BMI
- ≥ 10% BMI lossn = 679
- ≥ 10% BMI gainn = 705
- Outcome
- Systolic blood pressure
- Follow-up
- Median 4.4 years
Methodological detailsrepeated anthropometric and biochemical measurements ≈4 years apart, multivariable analysis of covariance, restricted cubic splines, multiple imputation for missing data
- Repeated anthropometric and biochemical measurements ≈4 years apart
- Multivariable analysis of covariance
- Restricted cubic splines
- Multiple imputation for missing data
Main finding
As reported in the abstract
Difference, mmHg (95% CI)
≥ 10% BMI lossvs Stable BMI (±5%)lower with ≥ 10% loss
−6.11(−7.14 to −5.07)
- ≥ 10% BMI gain vs Stable BMI (±5%) · higher with ≥ 10% gain
- difference +4.23 mmHg (95% CI 3.22–5.23)
Observational data: associations, not effects.
Further findings
| Outcome | Difference (CI) | |
|---|---|---|
| Triglycerides · median 4.4 years≥ 10% BMI lossvs Stable BMI (±5%)Lower with ≥ 10% loss | −23.4% (−25.7 to −21.0) | |
| C-reactive protein · median 4.4 years≥ 10% BMI lossvs Stable BMI (±5%)Lower with ≥ 10% loss | −39.5% (−43.7 to −35.1) | |
| −60−40−20020Difference (linear scale) |
| Outcome | Difference (CI) |
|---|---|
| Triglycerides · median 4.4 years≥ 10% BMI gain vs Stable BMI (±5%) · higher with ≥ 10% gain | +16.9% (13.4–20.5) |
| C-reactive protein · median 4.4 years≥ 10% BMI gain vs Stable BMI (±5%) · higher with ≥ 10% gain | +45.7% (36.0–56.1) |
Other cardiometabolic outcomes
- ≥ 10% loss associated with lower DBP, total and LDL cholesterol, HbA1c and SCORE2 and higher HDL cholesterol
- ≥ 10% gain associated with adverse differences across most outcomes
BMI vs waist-to-height ratio (WHtR) and non-linearity
- Associations were broadly similar for BMI and WHtR, with non-linearity for selected outcomes
Effect modification by sex
- Sex modified associations with DBP, lipids and SCORE2, with larger triglyceride reductions accompanying BMI loss in men
Original publication
Longitudinal Associations of Changes in Body Mass Index and Waist‐to‐Height Ratio With Cardiometabolic Risk Factors: Sex‐Specific Analyses in UK Biobank. Diabetes Obes Metab. Published 9 November 2026. doi:10.
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