Background
Materials and methods
Study population
Anthropometric and biochemical measurement
Questionnaire survey
Outcome and exposure definitions
Statistical analysis
Results
Baseline characteristics of the study population
Characteristics | Normal weight | p Value | Overweight | p Value | Obese | p Value | |||
---|---|---|---|---|---|---|---|---|---|
Metabolically healthy | Metabolically unhealthy | Metabolically healthy | Metabolically unhealthy | Metabolically healthy | Metabolically unhealthy | ||||
n (prevalence%) | 4874 (36.0) | 2099 (15.5) | ─ | 2235 (16.5) | 1843 (13.6) | ─ | 749 (5.5) | 1196 (8.8) | ─ |
Age (years) mean ± SD | 40.83 ± 14.75 | 47.45 ± 15.60 | < 0.001 | 45.56 ± 13.03 | 49.27 ± 12.93 | < 0.001 | 47.36 ± 12.46 | 50.97 ± 11.79 | < 0.001 |
Gender n (%) | 0.938 | 0.182 | 0.036 | ||||||
Male | 2183 (44.8) | 938 (44.7) | 1030 (46.1) | 888 (48.2) | 289 (38.6) | 519 (43.4) | |||
Female | 2691 (55.2) | 1161 (55.3) | 1205 (53.9) | 955 (51.8) | 460 (61.4) | 677 (56.6) | |||
Ethnicity n (%) | 0.919 | 0.172 | 0.240 | ||||||
Kazakh | 2376 (48.7) | 1019 (48.5) | 1054 (47.2) | 880 (47.7) | 447 (59.7) | 757 (63.3) | |||
Uyghur | 1488 (30.5) | 636 (30.3) | 440 (19.7) | 322 (17.5) | 100 (13.4) | 137 (11.5) | |||
Han | 1010 (20.7) | 444 (21.2) | 741 (33.2) | 641 (34.8) | 202 (27.0) | 302 (25.3) | |||
Educational level n (%) | < 0.001 | < 0.001 | 0.346 | ||||||
Illiteracy | 797 (16.4) | 447 (21.3) | 425 (19.0) | 431 (23.4) | 127 (17.0) | 228 (19.1) | |||
Primary school | 1993 (40.9) | 919 (43.8) | 968 (43.3) | 828 (44.9) | 353 (47.1) | 528 (44.1) | |||
≥ Junior high school | 2084 (42.8) | 733 (34.9) | 842 (37.7) | 584 (31.7) | 269 (35.9) | 440 (36.8) | |||
Smoking n (%) | 0.305 | 0.599 | 0.812 | ||||||
No | 3825 (78.5) | 1624 (77.4) | 1726 (77.2) | 1436 (77.9) | 584 (78.0) | 938 (78.4) | |||
Yes | 1049 (21.5) | 475 (22.6) | 509 (22.8) | 407 (22.1) | 165 (22.0) | 258 (21.6) | |||
Drinking n (%) | 0.929 | 0.176 | 0.744 | ||||||
No | 4355 (89.4) | 1877 (89.4) | 1906 (85.3) | 1599 (86.8) | 636 (84.9) | 1009 (84.4) | |||
Yes | 519 (10.6) | 222 (10.6) | 329 (14.7) | 244 (13.2) | 113 (15.1) | 187 (15.6) | |||
Fresh milk n (%) | 0.047 | 0.024 | 0.464 | ||||||
no or < 0.5 L per week | 3953 (81.1) | 1756 (83.7) | 1710 (76.5) | 1476 (80.1) | 558 (74.5) | 899 (75.2) | |||
0.5 L–1.5 L per week | 526 (10.8) | 188 (9.0) | 290 (13.0) | 212 (11.5) | 97 (13.0) | 167 (14.0) | |||
≥ 1.5 L per week | 395 (8.1) | 155 (7.4) | 235 (10.5) | 155 (8.4) | 94 (12.6) | 130 (10.9) | |||
Egg n (%) | 0.032 | 0.081 | 0.427 | ||||||
no or < 1 per week | 2342 (48.1) | 1091 (52.0) | 1110 (49.7) | 982 (53.3) | 433 (57.8) | 723 (60.5) | |||
1–3 per week | 1708 (35.0) | 694 (33.1) | 735 (32.9) | 584 (31.7) | 216 (28.8) | 322 (26.9) | |||
≥ 4 per week | 824 (16.9) | 314 (15.0) | 390 (17.4) | 277 (15.0) | 100 (13.4) | 151 (12.6) | |||
Fresh meat n (%) | 0.019 | 0.087 | < 0.001 | ||||||
no or < 1 kg per week | 1093 (22.4) | 463 (22.1) | 417 (18.7) | 315 (17.1) | 128 (17.1) | 156 (13.0) | |||
1-2 kg per week | 1601 (32.8) | 626 (29.8) | 643 (28.8) | 493 (26.7) | 210 (28.0) | 275 (23.0) | |||
≥ 2 kg per week | 2180 (44.7) | 1010 (48.1) | 1175 (52.6) | 1035 (56.2) | 411 (54.9) | 765 (64.0) | |||
Vegetables n (%) | < 0.001 | 0.002 | 0.080 | ||||||
no or < 1 plate per week | 340 (7.0) | 199 (9.5) | 120 (5.4) | 107 (5.8) | 30 (4.0) | 70 (5.9) | |||
1–3 plates per week | 2358 (48.4) | 1060 (50.5) | 866 (38.7) | 815 (44.2) | 284 (37.9) | 482 (40.3) | |||
≥ 4 plates per week | 2176 (44.6) | 840 (40.0) | 1249 (55.9) | 921 (50.0) | 435 (58.1) | 644 (53.8) | |||
Fruits n (%) | 0.007 | 0.009 | 0.193 | ||||||
no or < 1 plate per week | 978 (20.1) | 492 (23.4) | 456 (20.4) | 442 (24.0) | 169 (22.6) | 315 (26.3) | |||
1–3 plates per week | 2571 (52.7) | 1055 (50.3) | 1066 (47.7) | 877 (47.6) | 363 (48.5) | 549 (45.9) | |||
≥ 4 plates per week | 1325 (27.2) | 552 (26.3) | 713 (31.9) | 524 (28.4) | 217 (29.0) | 332 (27.8) | |||
WC (cm) mean ± SD | 79.22 ± 7.70 | 81.69 ± 8.37 | < 0.001 | 87.55 ± 7.75 | 89.69 ± 7.93 | < 0.001 | 97.52 ± 9.54 | 100.56 ± 10.26 | < 0.001 |
Prevalence of MHO in obese participants
All subjects | Male | Female | p Value a | |
---|---|---|---|---|
Overall n (%) | 749 (38.5) | 289 (35.8) | 460 (40.5) | 0.036 |
Age group n (%) | ||||
18–24 | 59 (62.1) | 18 (48.6) | 41 (70.7) | 0.031 |
25–34 | 147 (47.3) | 65 (43.9) | 82 (50.3) | 0.260 |
35–44 | 226 (40.2) | 81 (36.2) | 145 (42.9) | 0.111 |
45–54 | 186 (33.5) | 77 (32.9) | 109 (34.0) | 0.796 |
55–64 | 101 (32.1) | 39 (30.0) | 62 (33.5) | 0.511 |
≥ 65 | 30 (28.0) | 9 (25.7) | 21 (29.2) | 0.709 |
p trend | < 0.001 | < 0.001 | < 0.001 | |
Ethnicity n (%) | ||||
Kazakh | 447 (37.1) | 164 (33.5) | 283 (39.6) | 0.033 |
Uyghur | 100 (42.2) | 42 (37.5) | 58 (46.4) | 0.166 |
Han | 202 (40.1) | 83 (40.1) | 119 (40.1) | 0.995 |
p Value b | 0.240 | 0.235 | 0.354 |
Prevalence of MUNW in normal weight participants
All subjects | Male | Female | p Value a | |
---|---|---|---|---|
Overall n (%) | 2099 (30.1) | 938 (30.1) | 1161 (30.1) | 0.938 |
Age group n (%) | ||||
18–24 | 316 (19.3) | 173 (23.0) | 143 (16.1) | < 0.001 |
25–34 | 367 (24.0) | 164 (25.8) | 203 (22.7) | 0.164 |
35–44 | 440 (29.8) | 171 (30.1) | 269 (29.7) | 0.882 |
45–54 | 466 (38.5) | 177 (32.4) | 289 (43.6) | < 0.001 |
55–64 | 335 (44.6) | 163 (40.2) | 172 (49.7) | 0.009 |
≥ 65 | 175 (47.4) | 90 (42.3) | 85 (54.5) | 0.020 |
p trend | < 0.001 | < 0.001 | < 0.001 | |
Ethnicity n (%) | ||||
Kazakh | 1019 (30.0) | 435 (29.9) | 584 (30.1) | 0.915 |
Uyghur | 636 (29.9) | 334 (30.3) | 302 (29.5) | 0.703 |
Han | 444 (30.5) | 169 (29.9) | 275 (30.9) | 0.680 |
p Value b | 0.919 | 0.974 | 0.804 |
Associated factors of MHO in obese individuals
Characteristics | Unadjusted OR (95%CI) | Model 1 OR (95%CI) | Model 2 OR (95%CI) | Model 3 OR (95%CI) |
---|---|---|---|---|
Age (years) | ||||
18–24 | 1.00 | ─ | 1.00 | 1.00 |
25–34 | 0.55 (0.34,0.88) | ─ | 0.52 (0.32,0.85) | 0.56 (0.34,0.91) |
35–44 | 0.41 (0.26,0.64) | ─ | 0.37 (0.23,0.59) | 0.41 (0.25,0.65) |
45–54 | 0.31 (0.20,0.48) | ─ | 0.29 (0.18,0.46) | 0.32 (0.20,0.51) |
55–64 | 0.29 (0.18,0.46) | ─ | 0.27 (0.17,0.45) | 0.30 (0.18,0.50) |
≥ 65 | 0.24 (0.13,0.43) | ─ | 0.23 (0.12,0.43) | 0.26 (0.14,0.49) |
Gender | ||||
Male | 1.00 | ─ | 1.00 | 1.00 |
Female | 1.22 (1.01,1.47) | ─ | 1.30 (1.05,1.62) | 1.42 (1.13,1.77) |
Ethnicity | ||||
Kazakh | 1.00 | ─ | 1.00 | 1.00 |
Uyghur | 1.24 (0.93,1.64) | ─ | 1.06 (0.76,1.48) | 1.03 (0.73,1.44) |
Han | 1.13 (0.92,1.40) | ─ | 1.22 (0.93,1.61) | 1.14 (0.87,1.51) |
Educational Level | ||||
Illiteracy | 1.00 | 1.00 | 1.00 | 1.00 |
Primary school | 1.20 (0.93,1.55) | 1.24 (0.93,1.66) | 1.24 (0.93,1.66) | 1.26 (0.95,1.69) |
≥ Junior high school | 1.10 (0.84,1.43) | 1.05 (0.76,1.43) | 1.04 (0.75,1.43) | 1.05 (0.76,1.45) |
Smoking | ||||
No | 1.00 | 1.00 | 1.00 | 1.00 |
Yes | 1.03 (0.82,1.28) | 1.15 (0.90,1.46) | 1.11 (0.85,1.43) | 1.10 (0.85,1.42) |
Drinking | ||||
No | 1.00 | 1.00 | 1.00 | 1.00 |
Yes | 0.96 (0.74,1.24) | 1.04 (0.78,1.37) | 1.05 (0.78,1.40) | 1.04 (0.77,1.40) |
Fresh milk | ||||
no or < 0.5 L per week | 1.00 | 1.00 | 1.00 | 1.00 |
0.5 L–1.5 L per week | 0.94 (0.71,1.24) | 0.96 (0.72,1.28) | 0.93 (0.69,1.26) | 0.93 (0.69,1.26) |
≥ 1.5 L per week | 1.17 (0.86,1.60) | 1.24 (0.90,1.69) | 1.14 (0.82,1.58) | 1.14 (0.82,1.58) |
Egg | ||||
no or < 1 per week | 1.00 | 1.00 | 1.00 | 1.00 |
1–3 per week | 1.12 (0.88,1.43) | 1.06 (0.83,1.36) | 1.07 (0.83,1.39) | 1.05 (0.80,1.37) |
≥ 4 per week | 1.11 (0.80,1.52) | 0.96 (0.68,1.35) | 0.92 (0.64,1.33) | 0.90 (0.63,1.30) |
Fresh meat | ||||
no or < 1 kg per week | 1.00 | 1.00 | 1.00 | 1.00 |
1-2 kg per week | 0.93 (0.68,1.28) | 0.93 (0.67,1.28) | 0.85 (0.61,1.20) | 0.87 (0.61,1.23) |
≥ 2 kg per week | 0.66 (0.50,0.87) | 0.66 (0.49,0.90) | 0.61 (0.45,0.84) | 0.62 (0.45,0.85) |
Vegetables | ||||
no or < 1 plate per week | 1.00 | 1.00 | 1.00 | 1.00 |
1–3 plates per week | 1.39 (0.81,2.41) | 1.40 (0.79,2.49) | 1.48 (0.83,2.63) | 1.48 (0.83,2.64) |
≥ 4 plates per week | 1.59 (0.94,2.71) | 1.66 (0.94,2.92) | 1.84 (1.02,3.32) | 1.85 (1.02,3.35) |
Fruits | ||||
no or < 1 plate per week | 1.00 | 1.00 | 1.00 | 1.00 |
1–3 plates per week | 1.23 (0.97,1.55) | 1.16 (0.91,1.47) | 1.12 (0.87,1.43) | 1.11 (0.87,1.43) |
≥ 4 plates per week | 1.21 (0.93,1.57) | 1.07 (0.82,1.40) | 1.09 (0.83,1.43) | 1.08 (0.82,1.43) |
WC (cm) | ||||
< 90 (men) or < 80 (women) | 1.00 | ─ | ─ | 1.00 |
90–100 (men) or 80–90 (women) | 0.67 (0.42,1.08) | ─ | ─ | 0.71 (0.44,1.16) |
≥ 100 (men) or ≥ 90 (women) | 0.49 (0.31,0.76) | ─ | ─ | 0.51 (0.32,0.82) |
Associated factors of MUNW in normal weight individuals
Characteristics | Unadjusted OR (95%CI) | Model 1 OR (95%CI) | Model 2 OR (95%CI) | Model 3 OR (95%CI) |
---|---|---|---|---|
Age (years) | ||||
18–24 | 1.00 | ─ | 1.00 | 1.00 |
25–34 | 1.32 (1.12,1.57) | ─ | 1.35 (1.13,1.61) | 1.32 (1.11,1.57) |
35–44 | 1.78 (1.51,2.10) | ─ | 1.83 (1.54,2.19) | 1.74 (1.46,2.08) |
45–54 | 2.63 (2.22,3.11) | ─ | 2.72 (2.27,3.27) | 2.50 (2.07,3.01) |
55–64 | 3.37 (2.79,4.07) | ─ | 3.41 (2.78,4.18) | 3.10 (2.52,3.80) |
≥ 65 | 3.78 (2.98,4.79) | ─ | 3.70 (2.86,4.78) | 3.33 (2.57,4.31) |
Gender | ||||
Male | 1.00 | ─ | 1.00 | 1.00 |
Female | 1.00 (0.91,1.11) | ─ | 1.08 (0.96,1.22) | 0.96 (0.85,1.09) |
Ethnicity | ||||
Kazakh | 1.00 | ─ | 1.00 | 1.00 |
Uyghur | 1.00 (0.89,1.12) | ─ | 1.02 (0.88,1.19) | 1.00 (0.86,1.17) |
Han | 1.03 (0.90,1.17) | ─ | 0.91 (0.77,1.09) | 0.97 (0.81,1.15) |
Educational level | ||||
Illiteracy | 1.00 | 1.00 | 1.00 | 1.00 |
Primary school | 0.82 (0.72,0.95) | 0.91 (0.78,1.06) | 0.91 (0.78,1.07) | 0.90 (0.77,1.05) |
≥ Junior high school | 0.63 (0.54,0.72) | 0.92 (0.78,1.09) | 0.93 (0.79,1.11) | 0.92 (0.78,1.10) |
Smoking | ||||
No | 1.00 | 1.00 | 1.00 | 1.00 |
Yes | 1.07 (0.94,1.21) | 1.04 (0.91,1.20) | 1.03 (0.89,1.20) | 1.03 (0.89,1.19) |
Drinking | ||||
No | 1.00 | 1.00 | 1.00 | 1.00 |
Yes | 0.99 (0.84,1.17) | 1.08 (0.90,1.29) | 1.04 (0.86,1.26) | 1.04 (0.86,1.26) |
Fresh milk | ||||
no or < 0.5 L per week | 1.00 | 1.00 | 1.00 | 1.00 |
0.5 L–1.5 L per week | 0.81 (0.63,1.02) | 0.81 (0.63,1.04) | 0.82 (0.64,1.06) | 0.82 (0.63,1.07) |
≥ 1.5 L per week | 0.88 (0.71,1.10) | 0.87 (0.69,1.09) | 0.93 (0.72,1.20) | 0.92 (0.71,1.20) |
Egg | ||||
no or < 1 per week | 1.00 | 1.00 | 1.00 | 1.00 |
1–3 per week | 0.87 (0.76,1.00) | 0.90 (0.77,1.05) | 0.90 (0.77,1.06) | 0.90 (0.76,1.05) |
≥ 4 per week | 0.82 (0.66,1.01) | 0.85 (0.68,1.08) | 0.87 (0.68,1.11) | 0.86 (0.67,1.10) |
Fresh meat | ||||
no or < 1 kg per week | 1.00 | 1.00 | 1.00 | 1.00 |
1-2 kg per week | 0.92 (0.80,1.07) | 0.96 (0.82,1.12) | 1.05 (0.90,1.24) | 1.03 (0.88,1.22) |
≥ 2 kg per week | 1.09 (0.95,1.25) | 1.16 (0.99,1.35) | 1.27 (1.07,1.51) | 1.25 (1.05,1.48) |
Vegetables | ||||
no or < 1 plate per week | 1.00 | 1.00 | 1.00 | 1.00 |
1–3 plates per week | 0.77 (0.61,0.96) | 0.80 (0.63,1.03) | 0.81 (0.62,1.06) | 0.80 (0.61,1.05) |
≥ 4 plates per week | 0.66 (0.53,0.83) | 0.66 (0.51,0.85) | 0.65 (0.49,0.85) | 0.64 (0.48,0.85) |
Fruits | ||||
no or < 1 plate per week | 1.00 | 1.00 | 1.00 | 1.00 |
1–3 plates per week | 0.82 (0.72,0.93) | 0.91 (0.80,1.05) | 0.96 (0.82,1.11) | 0.96 (0.82,1.12) |
≥ 4 plates per week | 0.83 (0.72,0.96) | 0.95 (0.82,1.11) | 0.97 (0.82,1.13) | 0.95 (0.81,1.12) |
WC (cm) | ||||
< 90 (men) or < 80 (women) | 1.00 | ─ | ─ | 1.00 |
90–100 (men) or 80–90 (women) | 1.46 (1.30,1.64) | ─ | ─ | 1.32 (1.16,1.50) |
≥ 100 (men) or ≥ 90 (women) | 2.16 (1.77,2.65) | ─ | ─ | 1.72 (1.38,2.14) |