Complex interaction of waist circumference, cardiometabolic markers, and sex on elderly mortality: a cohort study of 0.4 million UK adults

Abstract This prospective cohort study included 408,760 older adults to investigate complex interaction between waist circumference (WC), blood glucose (BG) or blood pressure (BP), and sex in relation to elderly mortality. We used Cox regression models incorporating a tensor product interaction func...

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Main Authors: Jingyi Wu, Pengfei Li, Shaomei Shang
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:npj Metabolic Health and Disease
Online Access:https://doi.org/10.1038/s44324-025-00075-0
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author Jingyi Wu
Pengfei Li
Shaomei Shang
author_facet Jingyi Wu
Pengfei Li
Shaomei Shang
author_sort Jingyi Wu
collection DOAJ
description Abstract This prospective cohort study included 408,760 older adults to investigate complex interaction between waist circumference (WC), blood glucose (BG) or blood pressure (BP), and sex in relation to elderly mortality. We used Cox regression models incorporating a tensor product interaction function to model joint impacts of WC and four cardiometabolic markers on mortality, and developed a two-dimensional exposure-response function (ERF) to quantify the population adaptability to cardiometabolic dysfunction across different WC levels. The linear and nonlinear effects of BG and BP on mortality varied by WC, with significant synergistic interactions. The two-dimensional ERF quantified variations in excess mortality risk across different WC and cardiometabolic marker combinations. Individuals with higher WC exhibited a forward shift in risk thresholds, indicating reduced adaptability to elevated BG and BP levels. Our findings highlight the need for targeted cardiometabolic health management strategies to enhance adaptability and reduce the burden of cardiometabolic diseases in aging populations.
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spelling doaj-art-14263e645eea41028aa5e32fe7da3a8a2025-08-20T03:45:19ZengNature Portfolionpj Metabolic Health and Disease2948-28282025-07-01311910.1038/s44324-025-00075-0Complex interaction of waist circumference, cardiometabolic markers, and sex on elderly mortality: a cohort study of 0.4 million UK adultsJingyi Wu0Pengfei Li1Shaomei Shang2Advanced Institute of Information Technology, Peking UniversityAdvanced Institute of Information Technology, Peking UniversitySchool of Nursing, Peking UniversityAbstract This prospective cohort study included 408,760 older adults to investigate complex interaction between waist circumference (WC), blood glucose (BG) or blood pressure (BP), and sex in relation to elderly mortality. We used Cox regression models incorporating a tensor product interaction function to model joint impacts of WC and four cardiometabolic markers on mortality, and developed a two-dimensional exposure-response function (ERF) to quantify the population adaptability to cardiometabolic dysfunction across different WC levels. The linear and nonlinear effects of BG and BP on mortality varied by WC, with significant synergistic interactions. The two-dimensional ERF quantified variations in excess mortality risk across different WC and cardiometabolic marker combinations. Individuals with higher WC exhibited a forward shift in risk thresholds, indicating reduced adaptability to elevated BG and BP levels. Our findings highlight the need for targeted cardiometabolic health management strategies to enhance adaptability and reduce the burden of cardiometabolic diseases in aging populations.https://doi.org/10.1038/s44324-025-00075-0
spellingShingle Jingyi Wu
Pengfei Li
Shaomei Shang
Complex interaction of waist circumference, cardiometabolic markers, and sex on elderly mortality: a cohort study of 0.4 million UK adults
npj Metabolic Health and Disease
title Complex interaction of waist circumference, cardiometabolic markers, and sex on elderly mortality: a cohort study of 0.4 million UK adults
title_full Complex interaction of waist circumference, cardiometabolic markers, and sex on elderly mortality: a cohort study of 0.4 million UK adults
title_fullStr Complex interaction of waist circumference, cardiometabolic markers, and sex on elderly mortality: a cohort study of 0.4 million UK adults
title_full_unstemmed Complex interaction of waist circumference, cardiometabolic markers, and sex on elderly mortality: a cohort study of 0.4 million UK adults
title_short Complex interaction of waist circumference, cardiometabolic markers, and sex on elderly mortality: a cohort study of 0.4 million UK adults
title_sort complex interaction of waist circumference cardiometabolic markers and sex on elderly mortality a cohort study of 0 4 million uk adults
url https://doi.org/10.1038/s44324-025-00075-0
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AT shaomeishang complexinteractionofwaistcircumferencecardiometabolicmarkersandsexonelderlymortalityacohortstudyof04millionukadults