Metabolic obesity phenotypic stability, dynamic transformation and risk of hypertension: a 10-year prospective cohort study in southwest China
Authors' conclusion
Within the study population, MHO is an unstable state athat tended to progress to MUO, which carries the highest risk of hypertension. In contrast, the MUNW phenotype exhibits high reversibility and can revert to the MHNW phenotype.
Study context
- Population
- Participants of the Guizhou Population Health Cohort Study (GPHCS), southwest China, without hypertension at baseline; phenotypes by body mass index (BMI) and metabolic status
- Participants
- 3,399 participants
- Exposure
- Metabolic obesity phenotypes (metabolically unhealthy normal weight (MUNW), metabolically healthy obesity (MHO), metabolically unhealthy obesity (MUO)) vs metabolically healthy normal weight (MHNW), and 16 phenotype transition patterns
- Outcome
- Incident hypertension
- Follow-up
- Median 6.42 years
Methodological detailsGuizhou Population Health Cohort Study (GPHCS), multivariable-adjusted Cox proportional hazards models, multiple sensitivity analyses
- Guizhou Population Health Cohort Study (GPHCS)
- Multivariable-adjusted Cox proportional hazards models
- Multiple sensitivity analyses
Main finding
As reported in the abstract
Hypertension risk by baseline phenotype (826 incident cases)
Each group vs MHNWHazard ratio (95% CI)
MHO
1.26(1.02–1.55)
MUO
1.50(1.22–1.82)
MUNW
1.10(0.91–1.33)
Observational data: associations, not effects.
Further findings
Hypertension risk in participants who remained MHO
| HR (95% CI) | ||
|---|---|---|
| Remained MHO | 2.30 (1.45–3.64) | |
| 0.20.5125Hazard ratio (log scale) |
Phenotypic transitions during follow-up
- Participants who underwent phenotypic transitions
- 48.75%
- MUNW transitioned to MHNW
- 37.38%
- MHO transitioned to MUO
- 31.21%
Hypertension risk by phenotype transition
- Transitions from any baseline phenotype to MHNW: no statistically significant increase in hypertension risk
- all P > 0.05
- All other phenotypic transitions were positively associated with hypertension risk
Original publication
Metabolic obesity phenotypic stability, dynamic transformation and risk of hypertension: a 10-year prospective cohort study in southwest China. Int J Obes (Lond). Published 29 June 2026. doi:10.
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