marginally significantP = 0.013
However, after fully adjusting for confounding factors (Model 3), while cardiovascular mortality risk remained elevated (HR = 1.11, 95% CI: 1.00–1.23; P = 0.042), the overall risk of all-cause mortality associated with clinical obesity shifted to a marginally significant inverse relationship (HR = 0.93, 95% CI: 0.89–0.99; P = 0.013) compared to the no obesity group.