Central adiposity and sex are associated with the integrative architecture of physiological networks in healthy youth: a cross-sectional study in a cohort of Chinese college students.

BACKGROUND

The rising burden of cardiometabolic disease necessitates understanding how obesity and sex are associated with the integrative architecture of multi-system physiological networks in youth.

MATERIALS AND

METHODS

Using cross-sectional data from 3, 295 healthy Chinese young adults, we characterized the integrative physiological network architecture using Gaussian graphical modeling (EBICglasso). Network comparison tests, bootstrap resampling, and sensitivity analyses evaluated the effects of sex and different obesity indicators on network topology.

RESULTS

The analysis revealed a stable three-module network comprising body composition, autonomic, and cardiac subsystems. Waist circumference emerged as the most central node, exhibiting significantly higher expected influence (1.582) than body mass index or body fat percentage. Despite comparable global strength, distinct sex differences were observed: males displayed 3.123-fold stronger within-electrocardiographic module connectivity, whereas females demonstrated stronger cross-module connectivity between autonomic and cardiac systems. Obesity effects showed indicator heterogeneity: body mass index- and body fat percentage-defined obesity generally attenuated network connections, while waist circumference-defined obesity exhibited a distinct, non-attenuating pattern in females.

CONCLUSION

This study delineates a multi-system physiological network architecture in healthy Chinese youth, establishing waist circumference as the most central node and revealing that obesity associations with network topology differ by both anthropometric indicator and sex. These findings highlight the potential of integrative system-level physiology to complement isolated risk metrics for early cardiometabolic risk stratification.