{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:30:43Z","timestamp":1791833443944,"version":"4.3.4"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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\u2010ups with the risk of all\u2010cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected from 232,721 participants in the UK Biobank. Dysfunctions caused by obesity, in combination with an excess of anthropometric parameters, were used to diagnose clinical obesity. Participants were categorised into six clusters according to their baseline and follow\u2010up dysfunction status. Time\u2010dependent Cox proportional hazards regression was used to compare hazard ratios (HRs) for mortality across six clusters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In a total of 19,704 deaths over a mean follow\u2010up of 13.4\u00a0years, participants in Cluster 6 (clinical obesity at baseline; HR\u00a0=\u00a02.30, 95% CI: 2.16\u20132.44) and Cluster 3 (non\u2010obesity with baseline dysfunctions; HR\u00a0=\u00a02.02, 95% CI: 1.85\u20132.20) exhibited the highest multivariable\u2010adjusted mortality risk compared with participants without obesity and dysfunction at baseline and during follow\u2010up (Cluster 1). This was followed by participants in Cluster 2 (non\u2010obesity without baseline but with follow\u2010up dysfunctions; HR\u00a0=\u00a01.99, 95% CI: 1.88\u20132.10), Cluster 5 (preclinical obesity with follow\u2010up dysfunctions; HR\u00a0=\u00a01.97, 95% CI: 1.87\u20132.07), and Cluster 4 (preclinical obesity without follow\u2010up dysfunctions; HR\u00a0=\u00a01.15, 95% CI: 1.09\u20131.22). Subgroup analyses showed consistently higher mortality risks in Cluster 6 across various demographics, notably among individuals with higher educational qualifications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinical obesity was significantly associated with elevated all\u2010cause mortality risk. These findings underscore the importance of early screening and intervention for dysfunctions in patients with obesity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dmrr.70095","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T19:35:28Z","timestamp":1760643328000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Contributions of Clinical Obesity and Preclinical Obesity to the All\u2010Cause Mortality Risk: Findings From the UK Biobank Cohort"],"prefix":"10.1002","volume":"41","author":[{"given":"Manrong","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism Shanghai Clinical Center for Diabetes Shanghai Key Laboratory of Diabetes Mellitus Shanghai Key Clinical Center for Metabolic Disease Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai Diabetes Institute  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menghan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Shanghai Clinical Center for Diabetes Shanghai Key Laboratory of Diabetes Mellitus Shanghai Key Clinical Center for Metabolic Disease Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai Diabetes Institute  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yawen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Shanghai Clinical Center for Diabetes Shanghai Key Laboratory of Diabetes Mellitus Shanghai Key Clinical Center for Metabolic Disease Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai Diabetes Institute  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6073-4901","authenticated-orcid":false,"given":"Lianxi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Shanghai Clinical Center for Diabetes Shanghai Key Laboratory of Diabetes Mellitus Shanghai Key Clinical Center for Metabolic Disease Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai Diabetes Institute  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9850-122X","authenticated-orcid":false,"given":"Yun","family":"Shen","sequence":"additional","affiliation":[{"name":"Chronic Disease Epidemiology Laboratory Pennington Biomedical Research Center  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6172-8017","authenticated-orcid":false,"given":"Gang","family":"Hu","sequence":"additional","affiliation":[{"name":"Chronic Disease Epidemiology Laboratory Pennington Biomedical Research Center  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(25)00355\u20101"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41569\u2010023\u201000847\u20105"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2022.0225"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574\u2010021\u201000487\u20100"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.113905"},{"key":"e_1_2_11_7_1","unstructured":"C. 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