Modification of the association between obesity phenotypes and cardiovascular disease by social determinants of health: A prospective cohort study
Main finding · Incident CVDResult — go to the resultHazard ratio 1.75 95% CI 1.61–1.89Authors' conclusion
Obesity phenotypes were differentially associated with CVD risk, and these associations were shaped by social context. Individuals with lower SDOH burden may be more vulnerable to metabolic dysfunction. These findings highlight the need for prevention strategies that integrate both biological and social risk to improve CVD risk stratification.
Study context
- Population
- Chinese adults free of cardiovascular disease (CVD) at baseline, China PEACE Million Persons Project; mean age 53.9 years, 39.0% male
- Participants
- 89,237 adults
- Exposure
- Obesity phenotypes (by BMI and metabolic status) vs metabolically healthy normal weight; effect modification by social determinants of health (SDOH) burden
- Outcome
- Incident CVD
- Follow-up
- Median 3.47 years (IQR: 2.57-4.28)
Main finding
As reported in the abstract
median 3.47 years
Hazard ratio
1.75
95% CI 1.61–1.89
Metabolically unhealthy obesevs Metabolically healthy normal weight
HR 1.75 (95% CI 1.61–1.89)
- Incident CVD events
- 4999 (5.6%)
Observational data: associations, not effects.
Further findings
Effect modification by SDOH burden
- Associations modified by SDOH burden, stronger relative risks in low SDOH burden group
- P for interaction = 0.005
- High SDOH burden further increased CVD risk across most phenotypes (joint analyses)
- Modifying effect of SDOH more evident in older adults
Original publication
Modification of the association between obesity phenotypes and cardiovascular disease by social determinants of health: A prospective cohort study. Diabetes Obes Metab. Published 12 January 2026. doi:10.
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