Obesity Heterogeneity and Dyslipidemia in Urbanizing China

Background: Although obesity is a major risk factor for dyslipidemia, little is known about the heterogeneity of obesity, including differences in body fat distribution, the duration and timing of weight change, and whether they are associated with differential risk of dyslipidemia, especially in Asian populations. Methods: Using mixture models, latent classes were derived based on cross-sectional measures of waist circumference, % body fat in 2015 and longitudinal BMI data (from 1991 to 2015), for 6,258 adults (aged 18–66 years in 2015) from the China Health and Nutrition Survey. Descriptive statistics, as well as ANOVA and Chi-squared tests, were used to test for unadjusted differences by classes. We then used multivariable general linear mixed effects models to test for associations between these latent classes and both obesity measures and metabolic markers of dyslipidemia (LDL, HDL, total cholesterol, triglycerides, apo A, apo B, Lp a, and alanine aminotransferase). We controlled for age and sex in all models with random intercepts to control for community-level and household-level correlations. In the dyslipidemia-specific models we additionally controlled for BMI in 2015, alcohol use and smoking status. Results: Four of the five classes had comparable average BMI values in 2015 (from 23.17 kg/m2 (0.26 standard error (s.e.)) to 23.94 kg/m2 (0.94 s.e.)) after adjustment for age and sex but noticeable differences in change in BMI prior to 2015, waist circumference, and % body fat in 2015. Classes differed by sex, age, wave of entry, and number of survey waves. An association between latent class membership and HDL was identified, with the high overall obesity over time class having 3.22 mg higher average HDL values than the class with Lower BMI, High % Body Fat in 2015 class. Conclusion: Evidence of different patterns of obesity was found, with results indicating these patterns may be associated with differences in HDL values.Bachelor of Science in Public Healt