Abstract
BACKGROUND/OBJECTIVES: The definition of clinical obesity was newly announced. The aim of our study was to investigate the association of preclinical obesity and clinical obesity either at baseline or determined during follow-ups with the risk of autoimmune diseases (s) incidence. SUBJECTS/METHODS: Data were collected from 229,190 participants in the UK Biobank. Dysfunctions caused by obesity, in combination with anthropometric parameters, were used to diagnose clinical obesity. Seven prevalent ADs were analysed, including seropositive rheumatoid arthritis (PRA), psoriasis (PSO), multiple sclerosis (MS), systemic lupus erythematosus (SLE), myasthenia gravis (MG), Crohn's disease (CD), and ulcerative colitis (UC). According to obesity and dysfunction status, participants were categorized into six clusters. Time-dependent Cox model was used to compare hazard ratios (HRs) for ADs incidence across six clusters. RESULTS: In a total of 4938 ADs incidence events over a mean follow-up of 13.3 years, participants in Cluster 6 (clinical obesity at baseline; HR = 2.48, 95% CI: 2.222.78) and Cluster 3 (non-obesity and dysfunction at baseline; HR = 2.16, 95% CI: 1.83-2.55) exhibited the highest multivariable-adjusted mortality risk compared with participants without obesity and dysfunction at baseline and during follow-up (Cluster 1). Specific ADs analyses showed consistently higher incidence risks in Cluster 6, notably in PSO and PRA (HR = 4.31, 95% CI: 3.58-5.19 and HR = 3.63, 95% CI: 2.54-5.18, respectively). CONCLUSION: Clinical obesity was significantly associated with elevated ADs incidence risk. These findings underscore the importance of early screening and intervention of clinical obesity and dysfunctions due to obesity.