ArticleCell reports. Medicine2025
Phenotyping obesity through a two-dimensional tree structure reveals cardiometabolic heterogeneity.
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Article in Cell reports. Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6citing papers in PubMed
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Who cites it
6 citing papers in PubMed.
- Phenotypic Heterogeneity of Obesity and Short-Term Cardiometabolic Risk Factors Transitions: A Population-Based Cohort Study.Diabetes, obesity & metabolism · 2026Article
- Beyond MVPA minutes: physical activity phenotypes are associated with metabolic profiles in children with obesity.European journal of pediatrics · 2026Article
- DNA demethylation of ANXA4 is associated with atrial fibrillation risk through myeloid immune mechanisms: evidence from Mendelian randomization and multi-omics analyses.Clinical epigenetics · 2026Article
- Artificial Intelligence-Based Risk Stratification in Obesity Care: From Diagnosis to Personalised Treatment Pathways.Diagnostics (Basel, Switzerland) · 2026Review
- Central adiposity and sex influence lipid and glucose indices in Mexican adults: implications for metabolic risk assessment.Frontiers in nutrition · 2026Article
- From visualization to prediction: Dissecting metabolic heterogeneity with DDRTree.Cell reports. Medicine · 2025Article
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Authors and funding
50 authors.
Xiaojing JiaDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Hong LinDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Yilan DingDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Chunyan HuDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Shuangyuan WangDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Mian LiDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Yu XuDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Min XuDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Feiyue HuangDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Feixia ShenThe First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Xuejiang GuThe First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Yiming MuChinese People's Liberation Army General Hospital, Beijing, China.
Lulu ChenUnion Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Tianshu ZengUnion Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Lixin ShiAffiliated Hospital of Guiyang Medical College, Guiyang, China.
Qing SuXinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Xuefeng YuTongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Li YanSun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Guijun QinThe First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Qin WanThe Affiliated Hospital of Southwest Medical University, Luzhou, China.
Gang ChenFujian Provincial Hospital, Fujian Medical University, Fuzhou, China.
Xulei TangThe First Hospital of Lanzhou University, Lanzhou, China.
Zhengnan GaoDalian Municipal Central Hospital, Dalian, China.
Ruying HuZhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
Zuojie LuoThe First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Yingfen QinThe First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Li ChenQilu Hospital of Shandong University, Jinan, China.
Xinguo HouQilu Hospital of Shandong University, Jinan, China.
Yanan HuoJiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China.
Qiang LiThe Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Guixia WangThe First Hospital of Jilin University, Changchun, China.
Yinfei ZhangCentral Hospital of Shanghai Jiading District, Shanghai, China.
Chao LiuJiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China.
Youmin WangThe First Affiliated Hospital of Anhui Medical University, Hefei, China.
Shengli WuKaramay Municipal People's Hospital, Xinjiang, China.
Yujin ZhuKaramay Municipal People's Hospital, Xinjiang, China.
Tao YangThe First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Huacong DengThe First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Jiajun ZhaoShandong Provincial Hospital Affiliated to Shandong University, Jinan, China.
Yifang ZhangCenter for High Performance Computing, Shanghai Jiao Tong University, Shanghai, China.
Xingkun XuDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Huapeng WeiDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Jie ZhengDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Tiange WangDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Zhiyun ZhaoDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Guang NingDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Yuhong ChenDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Weiqing WangDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China. Electronic address: wqingw61@shsmu.edu.cn.
Yufang BiDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China. Electronic address: byf10784@rjh.com.cn.
Jieli LuDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China. Electronic address: ljl11319@rjh.com.cn.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Obesity, a major public health challenge, is characterized by substantial phenotypic heterogeneity. Here, we employ the discriminative dimensionality reduction tree (DDRTree) method to routine clinical data from 18,733 Chinese individuals with obesity enrolled in the nationwide China Cardiometabolic Disease and Cancer Cohort (4C) study. We identify five distinct metabolic phenotypes, among which the phenotype characterized by hyperglycemia and insulin resistance exhibits a higher risk of glycemic deterioration, while the phenotype characterized by hypertension and dyslipidemia demonstrates an elevated risk of microvascular and macrovascular diseases. These findings are validated in an independent prospective cohort. Additionally, we reveal distinctive metabolomic features that contribute to the heterogeneity of obesity in the 4C study. To translate our findings into practice, we develop a user-friendly online tool to assess event risks in the obese population. Overall, our analysis illustrates the underlying phenotypic variations influencing subsequent obesity-related outcomes, emphasizing the importance of precision medicine in obesity management.
Indexed as
Cardiovascular DiseasesObesityAdultChinaFemaleHumansInsulin ResistanceMaleMiddle AgedPhenotypeProspective Studiescardiovascular diseaseDDRTreediabetesheterogeneityobesity
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