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Clinical Research

Long-term impact of newly-proposed clinical obesity on autoimmune disease incidence: insights from the UK Biobank

International Journal of Obesity volume 50, pages 558–567 (2026)Cite this article

Subjects

Abstract

Background/Objectives

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-ups with the risk of autoimmune diseases (s) incidence.

Subjects/Methods

Data were collected from 229,190 participants in the UK Biobank. Dysfunctions caused by obesity, in combination with anthropometric parameters, were used to diagnose clinical obesity. Seven prevalent ADs were analysed, including seropositive rheumatoid arthritis (PRA), psoriasis (PSO), multiple sclerosis (MS), systemic lupus erythematosus (SLE), myasthenia gravis (MG), Crohn’s disease (CD), and ulcerative colitis (UC). According to obesity and dysfunction status, participants were categorized into six clusters. Time-dependent Cox model was used to compare hazard ratios (HRs) for ADs incidence across six clusters.

Results

In a total of 4938 ADs incidence events over a mean follow-up of 13.3 years, participants in Cluster 6 (clinical obesity at baseline; HR = 2.48, 95% CI: 2.222.78) and Cluster 3 (non-obesity and dysfunction at baseline; HR = 2.16, 95% CI: 1.83–2.55) exhibited the highest multivariable-adjusted mortality risk compared with participants without obesity and dysfunction at baseline and during follow-up (Cluster 1). Specific ADs analyses showed consistently higher incidence risks in Cluster 6, notably in PSO and PRA (HR = 4.31, 95% CI: 3.58–5.19 and HR = 3.63, 95% CI: 2.54–5.18, respectively).

Conclusion

Clinical obesity was significantly associated with elevated ADs incidence risk. These findings underscore the importance of early screening and intervention of clinical obesity and dysfunctions due to obesity.

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Fig. 1: Forest plot of fully adjusted hazard ratios between clusters.
Fig. 2: Kaplan-Meier survival curve for autoimmune disease among six clusters.

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Data availability

The raw UK Biobank data are protected and are not available due to data privacy laws. Researchers can apply to use the UK Biobank resource for health-related research and public interest via the UK Biobank Access Management System (https://ams.ukbiobank.ac.uk/ams/).

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Acknowledgements

We are grateful to all the participants of the UK Biobank and all the people involved in building the UK Biobank study.

Funding

Yun Shen was funded by the Collaboration in Action Program (CAP) 2024 supported by Our Lady of the Lake Health & Louisiana State University (LSU-OLOL-2024-06). Gang Hu was partially supported by the National Institute of General Medical Sciences (U54GM104940). Lianxi Li was funded by the National Natural Science Foundation of China (81770813 and 82070866). The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China

    Manrong Xu, Menghan Li, Yawen Zhang & Lianxi Li

  2. Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA

    Yun Shen & Gang Hu

Authors
  1. Manrong Xu
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  2. Menghan Li
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  6. Gang Hu
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Contributions

YS and LL: conceptualisation, resources, project administration, and supervision. MX: data curation, formal analysis, software, visualisation, and writing – original draft. YS, GH and LL: funding acquisition and investigation. GH, YS, ML, and YZ: methodology, validation, and writing– review & editing.

Corresponding authors

Correspondence to Lianxi Li or Yun Shen.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The UK biobank has the ethical approval from the North West Multi-centre Research Ethics Committee (approval number: 16/NW/0274). The present analysis plan was approved by both the UK Biobank data committee (Application ID: 177053). All participants signed informed consent. All methods were performed in accordance with the relevant guidelines and regulations.

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Xu, M., Li, M., Zhang, Y. et al. Long-term impact of newly-proposed clinical obesity on autoimmune disease incidence: insights from the UK Biobank. Int J Obes 50, 558–567 (2026). https://doi.org/10.1038/s41366-025-01970-8

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