Normal-Weight Obesity Is Associated with Increased Cardiometabolic Risk in Young Adults

Abstract

Normal-weight obesity (NWO) has been shown to be associated with cardiometabolic dysfunction. However, little is known regarding this potential relationship in early adulthood. The aim of this study was to investigate the associations between NWO and cardiometabolic risk factors in a large population of Colombian young adults. A cross-sectional study was conducted on 1354 subjects (61% women), aged from 18 to 30. Anthropometric data, including body mass index (BMI) and waist circumference (WC), were estimated, and the percentage of fat mass was measured through bioelectrical impedance analysis (BIA). Muscular fitness was determined by using a handgrip strength test and normalized grip strength (NGS = handgrip (kg)/body mass (kg)). A cardiometabolic risk Z-score was derived by assessing WC, triglycerides, high-density lipoprotein cholesterol (HDL-C) cholesterol, fasting glucose, and systolic blood pressure. NWO was defined by the combination of excess %BF (over 25.5% for men and 38.9% for women) and a BMI < 25 kg/m2. The overall prevalence of NWO was 29.1%. Subjects with NWO have an increased risk of cardiometabolic risk compared to the normal-weight lean group (OR = 3.10). Moreover, NWO was associated with an increased risk of presenting low HDL-C (OR = 2.34), high abdominal obesity (OR = 7.27), and low NGS (OR = 3.30), p < 0.001. There is a high prevalence of NWO in American Latin young adults and this condition is associated with an increased cardiovascular risk, high blood pressure, low HDL-C, high abdominal obesity, and low muscular strength early in life. Screening for adiposity in subjects with a normal BMI could help to identify young adults at a high risk of cardiometabolic abnormalities.

Normal-Weight Obesity Is Associated with Poorer Cardiometabolic Profile and Lower Physical Fitness Levels in Children and Adolescents

“…Despite these limitations, the main strength of our study is that, to our knowledge, this is the largest research on the relationship between NWO and cardiometabolic risk in a population of Latin American children and adolescents. These data from adolescents aged 9-17.9 years complement the study published by Correa-Rodríguez et al [25] on the use of the NWO in addition to body adiposity parameters in practice by general practitioners, teachers, and coaches in a school setting. Furthermore, highly standardized procedures were developed within the FUPRECOL study to avoid measurement bias [11].…”

“…Importantly, although the current study focused on the NWO in children and adolescents, this may not necessarily mean that the established health risks of HDL-C and blood pressure can be neglected. Therefore, the present analysis should be reproduced in a larger sample to validate whether in fact the paths are actually similar in both genders [25]. For this reason, given the potential influence of NWO on physical fitness, the findings of our study highlight the importance of considering body composition and CRF levels analysis [26] rather than only measuring BMI in future preventive studies and practices in a school setting.…”

Cardiometabolic risk and health behaviours in adolescents with normal-weight obesity: a systematic review

“…The expression was introduced by De Lorenzo et al (2006) (7) who adopted it as a criterion for identifying individuals with normal weight, yet with high percentage body fat. Studies carried out in adults indicate positive associations between NWO and cardiometabolic deregulation (8)(9)(10) .…”

Shared genetic etiology and causality between body fat percentage and cardiovascular diseases: a large-scale genome-wide cross-trait analysis

“…BF% is becoming recognized as a more predictive measurement in cardiovascular risk assessment than BMI or waist circumference, and increased BF% was often related to higher CVD risks with the presence of the metabolic abnormalities [ 25 , 68 ]. Genetic studies have suggested that most of the BF% loci also affect cardiometabolic traits and comorbidities [ 8 ].…”