Abstract
We aimed to determine the association of indices of body composition with abnormal metabolic phenotype, and to examine whether the strength of association was differentially distributed in different age groups in normal-weight Chinese adults. A total of 3015 normal-weight adults from a survey of Chinese people encompassing health and basic physiological parameters was included in this cross-sectional study. We investigated the association of body composition measured by bioelectrical impedance analysis and conventional body indices with metabolically unhealthy normal-weight (MUHNW) adults, divided by age groups and gender. Associations were assessed by multiple logistic regression analysis. We found abnormal metabolism in lean Chinese adults to be associated with higher adiposity indices (body mass index, BMI), waist circumference, and percentage body fat), lower skeletal muscle %, and body water %. Body composition was differentially distributed in age groups within the metabolically healthy normal weight (MHNW)/MUHNW groups. The impact of factors related to MUHNW shows a decreasing trend with advancing age in females and disparities of factors (BMI, body fat %, skeletal muscle %, and body water %) associated with the MUHNW phenotype in the elderly was noticed. Those factors remained unchanged in males throughout the age range, while the association of BMI, body fat %, skeletal muscle %, and body water % to MUHNW attenuated and grip strength emerged as a protective factor in elderly females. These results suggest that increased adiposity and decreased skeletal muscle mass are associated with unfavorable metabolic traits in normal-weight Chinese adults, and that MUHNW is independent of BMI, while increased waist circumference appears to be indicative of an abnormal metabolic phenotype in elderly females.
Highlights
The fact that obesity is a confirmed risk factor for chronic diseases including type 2 diabetes (T2DM) and cardiovascular diseases (CVD) has made it a major global health threat [1,2]
Our findings suggest that higher adiposity indices (BMI, waist circumference, body fat %), and lower skeletal muscle % and body water % are associated with abnormal metabolism in lean Chinese adults, and that the impact of factors related to the unhealthy metabolic phenotype shows a decreasing trend with increasing age in females
The current study and other studies of the Chinese population [24,25] have shown that Body mass index (BMI) and Waist circumference (WC) are higher in metabolically unhealthy normal-weight” (MUHNW) individuals regardless of gender, and this result is further supported by studies conducted in Korea [26,27]
Summary
The fact that obesity is a confirmed risk factor for chronic diseases including type 2 diabetes (T2DM) and cardiovascular diseases (CVD) has made it a major global health threat [1,2]. MUHNW individuals may be predisposed to similar adverse health outcomes as those observed with obese patients. Since they are not overweight or obese, they may not get adequate medical attention, increasing their risk for untreated complications, which has been supported by a limited number of studies. A Korean study showed MUHNW adults exhibited increased arterial stiffness and carotid atherosclerosis compared with metabolically healthy obese adults [7]. MUHNW adults were three-fold more likely to develop diabetes than metabolically healthy obese individuals; and both groups had a similar risk in developing subclinical atherosclerosis as metabolically unhealthy obese adults [8,9]. The highest risk of CVD and all-cause mortality of MUHNW adults was observed in a prospective cohort study with a median follow-up of ten years [6]
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