A Longitudinal Assessment of Adiposity Change on the Incidence of Different Cardiometabolic Diseases Among Adult Qataris

Anthropometric and body composition changes may contribute differently to cardiometabolic disease risk depending on fat distribution and sex. Few studies have examined these longitudinal changes in Middle Eastern populations. To evaluate how five-year changes in weight, visceral adipose tissue (VAT), waist circumference (WC), and waist-to-hip ratio (WHR) relate to incident elevated blood pressure (EBP), diabetes, and dyslipidemia in Qatari adults, and whether baseline adiposity modifies these associations. Data were drawn from 1,765 Qatari adults (755 females, 1,010 males) in the Qatar Biobank cohort with repeated measures over five years. Sex-stratified logistic regression models were used to assess how changes in adiposity measures predicted incident disease. Interaction terms tested effect modification by baseline adiposity. Participants had a mean baseline age of 40 years. Dyslipidemia was highly prevalent at baseline (68% in males, 63% in females), while incidence of EBP and diabetes was relatively low. VAT gain was associated with higher odds of incident EBP in both sexes (OR: 1.53, 95% CI: 1.19-1.97 for males; OR: 1.85, 95% CI: 1.11-3.11 for females), and with diabetes in males (OR: 1.61, 95% CI: 1.14-2.25). WC change in females was associated with dyslipidemia (OR: 1.06, 95% CI: 1.02-1.10), while weight gain was inversely associated with dyslipidemia among females with obesity (OR: 0.89, 95% CI: 0.81-0.98). WHR in males was associated with both EBP and dyslipidemia, suggesting it may capture VAT-related risk. Some associations varied by baseline adiposity, with stronger effects among those with lower baseline VAT or WC. The relationship between adiposity changes and cardiometabolic risk varies by disease, sex, and baseline adiposity. WHR and WC may serve as useful proxies for VAT in risk assessment, especially in resource-limited settings.