Evidence map›Paper›PMID 42151022›Full record

ArticleEBioMedicine2026

Adiposity-based obesity classification and cardiometabolic and kidney outcomes: a longitudinal UK Biobank analysis.

Sophie Gunnarsson, Cecilia Karlsson, Rashmi B Prasad, Sara F Hansson

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Article in EBioMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Sophie GunnarssonDepartment of Clinical Sciences, Diabetes and Endocrinology, CRC, Lund University, Malmö, Sweden; Translational Science and Clinical Development, Research and Early Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden. Electronic address: sophie.gunnarsson@med.lu.se.
Cecilia KarlssonLate-stage Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.
Rashmi B PrasadDepartment of Clinical Sciences, Diabetes and Endocrinology, CRC, Lund University, Malmö, Sweden.
Sara F HanssonTranslational Science and Clinical Development, Research and Early Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObesity is commonly diagnosed using BMI, which does not capture total adiposity or fat distribution, as highlighted by the recent Lancet D&E Commission report. We assessed the prognostic value of an adiposity-based classification combining body fat percentage (BF%) and waist circumference (WC) in relation to cardiometabolic and kidney outcomes and evaluated its concordance with BMI.

methodsWe classified 489,311 UK Biobank participants into five risk groups (Groups 1-5) with increasingly adverse adiposity profiles based on BF%-WC. Associations with three-point major adverse cardiovascular events (3P-MACE), type 2 diabetes (T2D), and chronic kidney disease (CKD) were estimated using cumulative incidence and Cox PH models. Comparison with BMI categories was visualised with an alluvial plot.

findingsOver a median 13.1 years (IQR 1.7), 24,778 (5.1%) participants experienced 3P-MACE, 30,376 (6.2%) had incident T2D, and 14,906 (3.0%) had incident CKD. The BF%-WC classification yielded stepwise risk stratification across endpoints. Compared to the reference Group 1, Group 5 had significantly higher risk: age- and sex-adjusted HR 9.23 (95% CI 8.70-9.83) for T2D, 2.27 (2.10-2.41) for CKD, and 1.63 (1.60-1.71) for 3P-MACE. Discordance with BMI was notable: 32.6% of individuals in the high-risk Group 5 had a BMI in the normal-to-overweight range, while the overweight category spanned all BF%-WC risk groups.

interpretationAn adiposity-based classification integrating BF% and WC associates significantly with cardiometabolic and kidney outcomes and reveals discordance with BMI, reinforcing the Commission's framing of obesity as a disease driven by excess adiposity.

fundingSciLifeLab & Wallenberg DDLS Program; Knut and Alice Wallenberg Foundation; Swedish Research Council (2021-02623); Vinnova (2023-04234).

Indexed as

AdiposityCardiovascular DiseasesObesityRenal Insufficiency, ChronicAdultAgedBiological Specimen BanksBody Mass IndexDiabetes Mellitus, Type 2FemaleHumansIncidenceLongitudinal StudiesMaleMiddle AgedPrognosisAdiposityAnthropometric measurementsBody fat percentageCardiometabolicCKDLongitudinal outcomeMACEObesityT2DWaist circumference

Identifiers

PMID42151022
PMCPMC13261713

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.