New Metabolic Health Definition Might Not Be a Reliable Predictor for Mortality in the Nonobese Chinese Population
Abstract Background A new metabolic health (MH) definition was proposed recently. We aimed to investigate the association between the new MH definition and all-cause mortality (ACM) in a nonobese Chinese population. Methods A total of 1157 participants with 15-year of follow-up were included for the present analysis. The association between MH and ACM were analyzed by Cox regression models with overlap weighting according to propensity score (PS) as primary analysis. Results At baseline, 920 (79.5%) participants were categorized as MH and 237 (20.5%) participants were categorized as metabolic unhealth (MUH) by this new definition. During follow-up, ACM occurred in 30 participants with mortality rate at 1.85% in MH group and 5.49% in MUH group, respectively. In the crude sample, Kaplan-Meier (K-M) analysis demonstrated a significantly lower ACM in MH group when compared to MUH group (log-rank p = 0.002). However, in multivariable Cox analysis, MH was not significantly associated with reduced ACM when compared to MUH with HR at 0.92 (95% CI: 0.32-2.64, p = 0.875). Moreover, overlap weighting-adjusted K-M analysis showed that the cumulative incidence of ACM was not significantly different between MH and MUH groups (adjusted p = 0.589). In the primary multivariable Cox analysis with overlap weighting, the HR for ACM was 0.70 (95% CI: 0.24-2.06, p = 0.519) in MH group in reference to MUH group. Additional PS analyses yielded similar results. Conclusion The new MH definition was not significantly associated with ACM in non-obese Chinese people. Further investigations are needed.