Table 9. Open in new tab Association of...

Outcomes	Obesity Subphenotypes During Adulthood (From 1979–1983 to 1998–2001)
Type 2 diabetes
Metabolic status–BMI score^b	186/2170	3.78 (3.15–4.53)^c	3.80 (3.14–4.59)^c
Dichotomized metabolic status–BMI score
High		10.59 (7.18–15.61)^c	10.32 (6.91–15.41)^c
Low		1.00 (reference)	1.00 (reference)
Hypertension (2014 JNC-8 criteria)
Metabolic status–BMI score^b	614/1328	1.93 (1.69–2.20)^c	1.86 (1.62–2.14)^c
Dichotomized metabolic status–BMI score
High		2.74 (2.16–3.46)^c	2.54 (1.99–3.25)^c
Low		1.00 (reference)	1.00 (reference)
Hypertension (2017 ACC/AHA criteria)
Metabolic status–BMI score^b	519/952	1.84 (1.54–2.18)^c	1.75 (1.46–2.11)^c
Dichotomized metabolic status–BMI score
High		2.52 (1.84–3.45)^c	2.30 (1.65–3.20)^c
Low		1.00 (reference)	1.00 (reference)
CKD/microalbuminuria
Metabolic status–BMI score^b	329/1478	1.58 (1.39–1.79)^c	1.42 (1.24–1.62)^c
Dichotomized metabolic status–BMI score
High		2.22 (1.75–2.81)^c	1.84 (1.43–2.38)^c
Low		1.00 (reference)	1.00 (reference)
CVD
Metabolic status–BMI score^b	380/2131	1.77 (1.59–1.96)^c	1.55 (1.39–1.72)^c
Dichotomized metabolic status–BMI score
High		2.71 (2.20–3.33)^c	2.13 (1.72–2.63)^c
Low		1.00 (reference)	1.00 (reference)
Cancer mortality
Metabolic status–BMI score^b	204/2478	1.40 (1.21–1.61)^c	1.13 (0.97–1.31)
Dichotomized metabolic status–BMI score
High		1.69 (1.29–2.23)^c	1.18 (0.89–1.57)
Low		1.00 (reference)	1.00 (reference)
Cardiovascular mortality
Metabolic status–BMI score^b	124/2478	1.95 (1.63–2.35)^c	1.55 (1.28–1.89)^c
Dichotomized metabolic status–BMI score
High		3.06 (2.10–4.46)^c	1.94 (1.33–2.84)^c
Low		1.00 (reference)	1.00 (reference)
All-cause mortality
Metabolic status–BMI score^b	555/2478	1.61 (1.48–1.76)^c	1.30 (1.19–1.42)^c
Dichotomized metabolic status–BMI score
High		2.32 (1.96–2.76)^c	1.55 (1.30–1.85)^c
Low		1.00 (reference)	1.00 (reference)

Outcomes

Obesity Subphenotypes During Adulthood (From 1979–1983 to 1998–2001)

Events/n

Unadjusted HR (95% CI)

Adjusted HR (95% CI)^a

Type 2 diabetes

Metabolic status–BMI score^b

186/2170

3.78 (3.15–4.53)^c

3.80 (3.14–4.59)^c

Dichotomized metabolic status–BMI score

High

10.59 (7.18–15.61)^c

10.32 (6.91–15.41)^c

Low

1.00 (reference)

Hypertension (2014 JNC-8 criteria)

Metabolic status–BMI score^b

614/1328

1.93 (1.69–2.20)^c

1.86 (1.62–2.14)^c

Dichotomized metabolic status–BMI score

High

2.74 (2.16–3.46)^c

2.54 (1.99–3.25)^c

Low

1.00 (reference)

Hypertension (2017 ACC/AHA criteria)

Metabolic status–BMI score^b

519/952

1.84 (1.54–2.18)^c

1.75 (1.46–2.11)^c

Dichotomized metabolic status–BMI score

High

2.52 (1.84–3.45)^c

2.30 (1.65–3.20)^c

Low

1.00 (reference)

CKD/microalbuminuria

Metabolic status–BMI score^b

329/1478

1.58 (1.39–1.79)^c

1.42 (1.24–1.62)^c

Dichotomized metabolic status–BMI score

High

2.22 (1.75–2.81)^c

1.84 (1.43–2.38)^c

Low

1.00 (reference)

CVD

Metabolic status–BMI score^b

380/2131

1.77 (1.59–1.96)^c

1.55 (1.39–1.72)^c

Dichotomized metabolic status–BMI score

High

2.71 (2.20–3.33)^c

2.13 (1.72–2.63)^c

Low

1.00 (reference)

Cancer mortality

Metabolic status–BMI score^b

204/2478

1.40 (1.21–1.61)^c

1.13 (0.97–1.31)

Dichotomized metabolic status–BMI score

High

1.69 (1.29–2.23)^c

1.18 (0.89–1.57)

Low

1.00 (reference)

Cardiovascular mortality

Metabolic status–BMI score^b

124/2478

1.95 (1.63–2.35)^c

1.55 (1.28–1.89)^c

Dichotomized metabolic status–BMI score

High

3.06 (2.10–4.46)^c

1.94 (1.33–2.84)^c

Low

1.00 (reference)

All-cause mortality

Metabolic status–BMI score^b

555/2478

1.61 (1.48–1.76)^c

1.30 (1.19–1.42)^c

Dichotomized metabolic status–BMI score

High

2.32 (1.96–2.76)^c

1.55 (1.30–1.85)^c

Low

1.00 (reference)

Outcomes	Obesity Subphenotypes During Adulthood (From 1979–1983 to 1998–2001)
Type 2 diabetes
Metabolic status–BMI score^b	186/2170	3.78 (3.15–4.53)^c	3.80 (3.14–4.59)^c
Dichotomized metabolic status–BMI score
High		10.59 (7.18–15.61)^c	10.32 (6.91–15.41)^c
Low		1.00 (reference)	1.00 (reference)
Hypertension (2014 JNC-8 criteria)
Metabolic status–BMI score^b	614/1328	1.93 (1.69–2.20)^c	1.86 (1.62–2.14)^c
Dichotomized metabolic status–BMI score
High		2.74 (2.16–3.46)^c	2.54 (1.99–3.25)^c
Low		1.00 (reference)	1.00 (reference)
Hypertension (2017 ACC/AHA criteria)
Metabolic status–BMI score^b	519/952	1.84 (1.54–2.18)^c	1.75 (1.46–2.11)^c
Dichotomized metabolic status–BMI score
High		2.52 (1.84–3.45)^c	2.30 (1.65–3.20)^c
Low		1.00 (reference)	1.00 (reference)
CKD/microalbuminuria
Metabolic status–BMI score^b	329/1478	1.58 (1.39–1.79)^c	1.42 (1.24–1.62)^c
Dichotomized metabolic status–BMI score
High		2.22 (1.75–2.81)^c	1.84 (1.43–2.38)^c
Low		1.00 (reference)	1.00 (reference)
CVD
Metabolic status–BMI score^b	380/2131	1.77 (1.59–1.96)^c	1.55 (1.39–1.72)^c
Dichotomized metabolic status–BMI score
High		2.71 (2.20–3.33)^c	2.13 (1.72–2.63)^c
Low		1.00 (reference)	1.00 (reference)
Cancer mortality
Metabolic status–BMI score^b	204/2478	1.40 (1.21–1.61)^c	1.13 (0.97–1.31)
Dichotomized metabolic status–BMI score
High		1.69 (1.29–2.23)^c	1.18 (0.89–1.57)
Low		1.00 (reference)	1.00 (reference)
Cardiovascular mortality
Metabolic status–BMI score^b	124/2478	1.95 (1.63–2.35)^c	1.55 (1.28–1.89)^c
Dichotomized metabolic status–BMI score
High		3.06 (2.10–4.46)^c	1.94 (1.33–2.84)^c
Low		1.00 (reference)	1.00 (reference)
All-cause mortality
Metabolic status–BMI score^b	555/2478	1.61 (1.48–1.76)^c	1.30 (1.19–1.42)^c
Dichotomized metabolic status–BMI score
High		2.32 (1.96–2.76)^c	1.55 (1.30–1.85)^c
Low		1.00 (reference)	1.00 (reference)

Table 9.

Open in new tab

Association of the Summary Score for Obesity Subphenotypes During Attended Examinations and Outcomes During Follow-Up (1998–2001 to 2011–2014) Among Participants With Complete Data From Baseline to Last Examination (1987–1991 to 1998–2001)

Outcomes	Obesity Subphenotypes During Adulthood (From 1979–1983 to 1998–2001)
Outcomes	Events/n	Unadjusted HR (95% CI)	Adjusted HR (95% CI)^a
Type 2 diabetes
Metabolic status–BMI score^b	186/2170	3.78 (3.15–4.53)^c	3.80 (3.14–4.59)^c
Dichotomized metabolic status–BMI score
High		10.59 (7.18–15.61)^c	10.32 (6.91–15.41)^c
Low		1.00 (reference)	1.00 (reference)
Hypertension (2014 JNC-8 criteria)
Metabolic status–BMI score^b	614/1328	1.93 (1.69–2.20)^c	1.86 (1.62–2.14)^c
Dichotomized metabolic status–BMI score
High		2.74 (2.16–3.46)^c	2.54 (1.99–3.25)^c
Low		1.00 (reference)	1.00 (reference)
Hypertension (2017 ACC/AHA criteria)
Metabolic status–BMI score^b	519/952	1.84 (1.54–2.18)^c	1.75 (1.46–2.11)^c
Dichotomized metabolic status–BMI score
High		2.52 (1.84–3.45)^c	2.30 (1.65–3.20)^c
Low		1.00 (reference)	1.00 (reference)
CKD/microalbuminuria
Metabolic status–BMI score^b	329/1478	1.58 (1.39–1.79)^c	1.42 (1.24–1.62)^c
Dichotomized metabolic status–BMI score
High		2.22 (1.75–2.81)^c	1.84 (1.43–2.38)^c
Low		1.00 (reference)	1.00 (reference)
CVD
Metabolic status–BMI score^b	380/2131	1.77 (1.59–1.96)^c	1.55 (1.39–1.72)^c
Dichotomized metabolic status–BMI score
High		2.71 (2.20–3.33)^c	2.13 (1.72–2.63)^c
Low		1.00 (reference)	1.00 (reference)
Cancer mortality
Metabolic status–BMI score^b	204/2478	1.40 (1.21–1.61)^c	1.13 (0.97–1.31)
Dichotomized metabolic status–BMI score
High		1.69 (1.29–2.23)^c	1.18 (0.89–1.57)
Low		1.00 (reference)	1.00 (reference)
Cardiovascular mortality
Metabolic status–BMI score^b	124/2478	1.95 (1.63–2.35)^c	1.55 (1.28–1.89)^c
Dichotomized metabolic status–BMI score
High		3.06 (2.10–4.46)^c	1.94 (1.33–2.84)^c
Low		1.00 (reference)	1.00 (reference)
All-cause mortality
Metabolic status–BMI score^b	555/2478	1.61 (1.48–1.76)^c	1.30 (1.19–1.42)^c
Dichotomized metabolic status–BMI score
High		2.32 (1.96–2.76)^c	1.55 (1.30–1.85)^c
Low		1.00 (reference)	1.00 (reference)

Outcomes	Obesity Subphenotypes During Adulthood (From 1979–1983 to 1998–2001)
Outcomes	Events/n	Unadjusted HR (95% CI)	Adjusted HR (95% CI)^a
Type 2 diabetes
Metabolic status–BMI score^b	186/2170	3.78 (3.15–4.53)^c	3.80 (3.14–4.59)^c
Dichotomized metabolic status–BMI score
High		10.59 (7.18–15.61)^c	10.32 (6.91–15.41)^c
Low		1.00 (reference)	1.00 (reference)
Hypertension (2014 JNC-8 criteria)
Metabolic status–BMI score^b	614/1328	1.93 (1.69–2.20)^c	1.86 (1.62–2.14)^c
Dichotomized metabolic status–BMI score
High		2.74 (2.16–3.46)^c	2.54 (1.99–3.25)^c
Low		1.00 (reference)	1.00 (reference)
Hypertension (2017 ACC/AHA criteria)
Metabolic status–BMI score^b	519/952	1.84 (1.54–2.18)^c	1.75 (1.46–2.11)^c
Dichotomized metabolic status–BMI score
High		2.52 (1.84–3.45)^c	2.30 (1.65–3.20)^c
Low		1.00 (reference)	1.00 (reference)
CKD/microalbuminuria
Metabolic status–BMI score^b	329/1478	1.58 (1.39–1.79)^c	1.42 (1.24–1.62)^c
Dichotomized metabolic status–BMI score
High		2.22 (1.75–2.81)^c	1.84 (1.43–2.38)^c
Low		1.00 (reference)	1.00 (reference)
CVD
Metabolic status–BMI score^b	380/2131	1.77 (1.59–1.96)^c	1.55 (1.39–1.72)^c
Dichotomized metabolic status–BMI score
High		2.71 (2.20–3.33)^c	2.13 (1.72–2.63)^c
Low		1.00 (reference)	1.00 (reference)
Cancer mortality
Metabolic status–BMI score^b	204/2478	1.40 (1.21–1.61)^c	1.13 (0.97–1.31)
Dichotomized metabolic status–BMI score
High		1.69 (1.29–2.23)^c	1.18 (0.89–1.57)
Low		1.00 (reference)	1.00 (reference)
Cardiovascular mortality
Metabolic status–BMI score^b	124/2478	1.95 (1.63–2.35)^c	1.55 (1.28–1.89)^c
Dichotomized metabolic status–BMI score
High		3.06 (2.10–4.46)^c	1.94 (1.33–2.84)^c
Low		1.00 (reference)	1.00 (reference)
All-cause mortality
Metabolic status–BMI score^b	555/2478	1.61 (1.48–1.76)^c	1.30 (1.19–1.42)^c
Dichotomized metabolic status–BMI score
High		2.32 (1.96–2.76)^c	1.55 (1.30–1.85)^c
Low		1.00 (reference)	1.00 (reference)

Abbreviations: ACC, American College of Cardiology; AHA, American Heart Association; JNC-8: Eighth Joint National Committee.

Adjusted for age, sex, and current smoking.

Metabolic status–BMI score is an average score calculated as the sum of scores corresponding to each metabolic–BMI status at each examination (MHNO = 1, MHO = 2, MUNO = 3, and MUO = 4) divided by the number of attended examinations. A high score is a score above the median.

Association was significant at the Bonferroni-adjusted α level (P < 0.007).

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