biostudies-literatureJia XScience and Technology Commission of Shanghai MunicipalityShanghai Municipal Health CommissionInnovative Research Team of High-level Local Universities in ShanghaiMinistry of Science and Technology of the People's Republic of ChinaNational Natural Science Foundation of China102309https://www.ebi.ac.uk/biostudies/studies/S-EPMC12490207biostudies-literatureUnknown6(9)Current obesity classifications may not adequately reflect age- and gender-specific risks in diverse populations. In a prospective cohort study of 166,285 Chinese adults aged ≥40 years without prior cardiovascular disease (CVD) or cancer, we evaluate optimal thresholds of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) for predicting incident CVD and all-cause mortality. We observe monotonically increasing dose-response associations of BMI, WC, and WHR with CVD risk but U-shaped relationships with all-cause mortality. The optimal obesity thresholds based on all-cause mortality risk differ by gender, with the lowest mortality risks occurring at BMI 26.3 kg/m², WC 88 cm, and WHR 0.90 in men and BMI 25.4 kg/m², WC 83 cm, and WHR 0.85 in womeCell reports. MedicineRevisiting obesity thresholds for cardiovascular disease and mortality risk in Chinese adults: Age- and gender-specific insights.PMC12490207821708192022YFC2505202822009982023ZD05089012023ZD050890222Y319003002023ZD0508402820881022023ZD050840323Y1190840023JS14009002023ZD050840120214Y000220224Y0087823708108237234791857205Shi LWan QLuo ZQin YWang GHou XZhao ZDeng HYe ZShen FSu QWang T4C Study GroupWu SJia XChen YWang WWang YZhao JYu XTang XYin YYan LXu MQiao HGu XLi DMu YChen LChen GZheng RLi QLi MZeng TNing GHu CHuo YZhang YLu JLin HGao ZQin GLiu CLai SYang THu RXu YBi YfalseRevisiting obesity thresholds for cardiovascular disease and mortality risk in Chinese adults: Age- and gender-specific insights.Current obesity classifications may not adequately reflect age- and gender-specific risks in diverse populations. In a prospective cohort study of 166,285 Chinese adults aged ≥40 years without prior cardiovascular disease (CVD) or cancer, we evaluate optimal thresholds of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) for predicting incident CVD and all-cause mortality. We observe monotonically increasing dose-response associations of BMI, WC, and WHR with CVD risk but U-shaped relationships with all-cause mortality. The optimal obesity thresholds based on all-cause mortality risk differ by gender, with the lowest mortality risks occurring at BMI 26.3 kg/m², WC 88 cm, and WHR 0.90 in men and BMI 25.4 kg/m², WC 83 cm, and WHR 0.85 in wome2025-01-01T00:00:00Z2025 Sep2026-06-04T02:20:47.603Z2026-05-04T03:13:33.275ZS-EPMC124902074085810410.1016/j.xcrm.2025.102309