Frontiers in Endocrinology (Oct 2024)

Metabolic obesity phenotypes and the risk of cancer: a prospective study of the Kailuan cohort

  • Xin Zheng,
  • Xin Zheng,
  • Xin Zheng,
  • Xin Zheng,
  • Yiming Wang,
  • Yue Chen,
  • Yue Chen,
  • Yue Chen,
  • Yue Chen,
  • Yue Chen,
  • Tong Liu,
  • Tong Liu,
  • Tong Liu,
  • Tong Liu,
  • Chenan Liu,
  • Chenan Liu,
  • Chenan Liu,
  • Chenan Liu,
  • Shiqi Lin,
  • Shiqi Lin,
  • Shiqi Lin,
  • Shiqi Lin,
  • Shiqi Lin,
  • Hailun Xie,
  • Hailun Xie,
  • Hailun Xie,
  • Hailun Xie,
  • Xiangming Ma,
  • Ziwen Wang,
  • Ziwen Wang,
  • Ziwen Wang,
  • Ziwen Wang,
  • Jinyu Shi,
  • Jinyu Shi,
  • Jinyu Shi,
  • Jinyu Shi,
  • Heyang Zhang,
  • Heyang Zhang,
  • Heyang Zhang,
  • Heyang Zhang,
  • Ming Yang,
  • Ming Yang,
  • Ming Yang,
  • Ming Yang,
  • Xiaoyue Liu,
  • Xiaoyue Liu,
  • Xiaoyue Liu,
  • Xiaoyue Liu,
  • Li Deng,
  • Li Deng,
  • Li Deng,
  • Li Deng,
  • Qingsong Zhang,
  • Hanping Shi,
  • Hanping Shi,
  • Hanping Shi,
  • Hanping Shi

DOI
https://doi.org/10.3389/fendo.2024.1333488
Journal volume & issue
Vol. 15

Abstract

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BackgroundObesity is as an important risk factor for chronic diseases. Metabolically healthy obesity (MHO) is considered a benign state. The association between metabolic health and obesity categories and cancer risk remains unclear. This study aimed to investigate the relationship between metabolic health status combined with obesity phenotypes and the risk of cancer.MethodsData from 91,834 participants in the Kailuan cohort were analyzed, excluding individuals with a body mass index (BMI) < 18.5 kg/m² and those with a history of cancer. Obesity phenotypes were classified based on BMI and waist circumference (WC) combined with metabolic health status, resulting in six phenotypes. Cox proportional hazard regression models were used to assess the association between metabolic health and obesity phenotypes with cancer risk and all-cause mortality.ResultsThe prevalence of metabolically healthy obesity and metabolically unhealthy obesity defined by BMI was 6.86% and 12.18%, while that defined by WC was 20.79% and 25.76%, respectively. Compared to metabolically healthy participants, individuals with an unhealthy metabolic status had a significantly higher risk of cancer (HR, 1.09; 95% CI, 1.03–1.15; p=0.004). The hazard ratios for cancer were 1.19, 1.23, 1.20, and 1.55 for individuals with one, two, three, and four metabolic disorders, respectively. Among those classified as metabolically unhealthy, both overweight and obesity were associated with a protective effect on cancer risk (HR, 0.88; 95% CI, 0.80–0.96; p=0.006 for overweight; HR, 0.87; 95% CI, 0.78–0.97; p=0.010 for obesity). However, abdominal obesity significantly increased cancer risk in both metabolically healthy and unhealthy participants. In subgroup analysis, simple obesity showed a protective trend against cancer in those with respiratory cancers, while abdominal obesity consistently posed a risk for various cancer types.ConclusionMetabolically unhealthy status and abdominal obesity are risk factors for cancer and all-cause mortality, whereas simple obesity offers protective effects against cancer and all-cause mortality in metabolically unhealthy individuals. These findings suggest that maintaining metabolic health and reducing the metabolic risks associated with abdominal obesity should be key targets for cancer prevention.

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