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A CLPN model was used to estimate bidirectional longitudinal associations between obesity and CMDs between participant\u2010specific first and last eligible surveys. CMDs included hypertension (HBP), diabetes (DM), ischaemic heart disease (IHD) and cerebrovascular disease (CVD). Network replicability was assessed across cohorts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Across cohorts, 3.43%\u20135.49% of participants transitioned from non\u2010obese to obese status, while 16.44%\u201326.03% transitioned from no CMD to CMD status. Three networks showed moderate structural similarity, with 12 directionally concordant obesity\u2010CMD edges and moderate edge\u2010weight correlations (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.59\u20130.64; all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). The obesity\u2010to\u2010diabetes edge was the strongest directed association in CHARLS (OR 2.59, 95% CI:2.18\u20133.11) and CFPS (2.77, 2.31\u20133.29), and the second strongest in CHNS (3.43, 2.67\u20134.31). Among obesity\u2010originating edges, the same rank order (diabetes, hypertension, IHD and CVD) was observed across cohorts. Obesity showed the highest out\u2010expected influence and the lowest in\u2010expected influence. A positive hypertension\u2010to\u2010obesity association and bidirectional hypertension\u2010diabetes associations were consistently observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CMDs are highly interrelated, and obesity plays a central role in bridging CMDs in the longitudinal networks, highlighting its relevance to both individual CMDs and their clustering as cardiometabolic multimorbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71414","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:04:07Z","timestamp":1791356647000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Obesity and the Development of Cardiometabolic Multimorbidity: A Cross\u2010Lagged Panel Network Analysis of Three National Chinese Cohorts"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8707-4423","authenticated-orcid":false,"given":"Zeping","family":"Fang","sequence":"first","affiliation":[{"name":"China\u2010Australia Joint Research Center for Infectious Diseases, School of Public Health Xi'an Jiaotong University Health Science Center  Xi'an Shaanxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4220-842X","authenticated-orcid":false,"given":"Jinli","family":"Liu","sequence":"additional","affiliation":[{"name":"China\u2010Australia Joint Research Center for Infectious Diseases, School of Public Health Xi'an Jiaotong University Health Science Center  Xi'an Shaanxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2343-084X","authenticated-orcid":false,"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[{"name":"China\u2010Australia Joint Research Center for Infectious Diseases, School of Public Health Xi'an Jiaotong University Health Science Center  Xi'an Shaanxi People's Republic of China"},{"name":"Phase I Clinical Trial Research Ward The Second Affiliated Hospital of Xi'an Jiaotong University  Xi'an Shaanxi People's Republic of China"},{"name":"Artificial Intelligence and Modelling in Epidemiology Program, Melbourne Sexual Health Centre Alfred Health  Melbourne Australia"},{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne 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