Normal body weight with central obesity increases newly onset cardiovascular disease in adults from rural Northeast China

Background: Cumulative evidence indicates that normal weight with central obesity (NWCO) is associated with cardiovascular diseases risk factors like hypertension, diabetes, dyslipidemia. However, the possible predictive effect of NWCO on newly onset cardiovascular diseases (CVD) including coronary heart disease (CHD) and stroke has not been studied in detail. Methods Participants underwent physical examination at 2012–2013 and followed-up at 2015–2017 who previously diagnosed CVD were excluded. Body mass index (BMI) ≥ 25 kg/m 2 defined obesity, waist-to-height ratio ≥ 0.5 defined central obesity. Four groups: Normal weight without (NW) or NWCO, obesity without (OB) or with central obesity (OBCO). Results In total, 9439 participants (5006 men and 4433 women). The prevalence of different types of obesity were 39.6% for NW, 16.1% for NWCO, 4.1% for OB and 40.2% for OBCO. NWCO [HR = 1.565, 95%CI = 1.195, 2.051] and OBCO [HR = 1.845, 95%CI = 1.480, 2.300] were significantly associated with increasing risk of newly onset CVD. Besides, NWCO [HR = 2.337, 95%CI = 1.257, 4.344], OB [HR = 3.22, 95%CI = 1.166, 8.905] and OBCO [HR = 2.449, 95%CI = 1.386, 4.326] were all correlated with newly onset CHD but none of them had relationship with newly onset stroke. Conclusions We found that NWCO and OBCO were associated with newly onset CVD in rural Northeast Chinese adults. This underscored the effect of central obesity on CVD and suggested that even in individual with normal BMI, it is still necessary to prevent, monitor and control of central obesity.