Association between normal-weight central obesity and cardiometabolic disorders: a longitudinal analysis from health check-up data

Although several cross-sectional studies have examined the relationship between normal-weight central obesity (NWCO) and the risk of cardiometabolic disorders (CMD), longitudinal evidence from cohort studies is still limited, especially regarding diverse CMD outcomes in Chinese populations. We conducted a retrospective cohort study by using health examination records from Jiangsu Province Geriatric Hospital. The study included 5,606 normal-weight (body mass index of 18.0–24.0 kg/m 2 ) participants free of CMD at their baseline visit in 2022. NWCO was defined as normal-weight and central obesity (waist circumference ≥ 90 cm for men or ≥ 80 cm for women), whereas normal-weight non-central obesity (NWNO) was defined as normal-weight without central obesity. Participants were followed until the occurrence incident CMD events or the last visit in 2024. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for CMD and its related components. Among all participants (median age 40 years), 388 (6.9%) had NWCO. During a mean follow-up of 1.98 \(\:\pm\:\) 0.18 years, NWCO was associated with a greater risk for CMD (HR: 1.39, 95% CI: 1.13–1.71) compared with NWNO group. Similar risk elevations were observed for CMD components, including hypertension (HTN), diabetes mellitus (DM) and hyperlipidemia (HLP). Our analysis of a longitudinal health check-up database demonstrated the potential impact of NWCO on the risk for CMD, confirming the importance of abdominal obesity in the development of CMD even in normal-weight individuals.