Adiposity indicators exhibit depot- and sex-specific associations with multimorbidity onset: A cohort study of the UK Biobank

Lu Ma; Ying Li; Gaixia Li; Jiajun Sun; Xueli Zhang; Zumin Shi; Yating Yan; Yutian Duan; Jing Wang; Zengbin Li; Lei Zhang

doi:10.1111/dom.15610

Adiposity indicators exhibit depot- and sex-specific associations with multimorbidity onset: A cohort study of the UK Biobank

Diabetes Obes Metab. 2024 Apr 30. doi: 10.1111/dom.15610. Online ahead of print.

Authors

Lu Ma^{1

2}, Ying Li³, Gaixia Li⁴, Jiajun Sun^{5

6}, Xueli Zhang^{7

8}, Zumin Shi⁹, Yating Yan¹, Yutian Duan¹⁰, Jing Wang⁴, Zengbin Li⁴, Lei Zhang^{2

4

5

6}

Affiliations

¹ School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.
² Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, China.
³ Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
⁴ China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.
⁵ Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
⁶ Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia.
⁷ Medical Research Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
⁸ Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
⁹ Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar.
¹⁰ Clinical Medicine, Xi'an Jiaotong University Health Science Center, Xi'an, China.

PMID: 38686512
DOI: 10.1111/dom.15610

Abstract

Aim: This study investigated the depot- and sex-specific associations of adiposity indicators with incident multimorbidity and comorbidity pairs.

Materials and methods: We selected 382 678 adults without multimorbidity (≥2 chronic diseases) at baseline from the UK Biobank. General obesity, abdominal obesity and body fat percentage indices were measured.

Results: Cox proportional hazard regression analyses of general obesity indices revealed that for every one-unit increase in body mass index, the risk of incident multimorbidity increased by 5.2% (95% confidence interval 5.0%-5.4%). A dose-response relationship was observed between general obesity degrees and incident multimorbidity. The analysis of abdominal obesity indices showed that for every 0.1 increment in waist-to-height ratio and waist-to-hip ratio, the risk of incident multimorbidity increased by 42.0% (37.9%-46.2%) and 27.9% (25.7%-30.0%), respectively. Central obesity, as defined by waist circumference, contributed to a 23.2% increased risk of incident multimorbidity. Hip circumference and hip-to-height ratio had protective effects on multimorbidity onset. Consistent findings were observed for males and females. Body fat percentage elevated 3% (0.2%-5.9%) and 5.3% (1.1%-9.7%) risks of incident multimorbidity in all adults and females, respectively. Arm fat percentages elevated 5.3% (0.8%-9.9%) and 19.4% (11.0%-28.5%) risks of incident multimorbidity in all adults and males, respectively. The general obesity indices, waist circumference, waist-to-height ratio, waist-to-hip ratio and central obesity increased the onset of comorbidity pairs, whereas hip circumference and hip-to-height ratio decreased the onset of comorbidity pairs. These adiposity indicators mainly affect diabetes mellitus-related comorbidity onset in males and hypertensive-related comorbidity onset in females.

Conclusions: Adiposity indicators are predictors of multimorbidity and comorbidity pairs and represent a promising approach for intervention.

Keywords: adults; body fat percentage; central obesity; general obesity; multimorbidity.

Abstract

Grants and funding