Abstract
We hypothesized that subjects with a normal body mass index (BMI), but high body fat (BF) content [normal weight obesity (NWO)], have a higher prevalence of cardiometabolic dysregulation and are at higher risk for cardiovascular (CV) mortality. We analysed 6171 subjects >20 years of age from the Third National Health and Nutrition Examination Survey (NHANES III) and the NHANES III mortality study, whose BMI was within the normal range (18.5-24.9 kg/m(2)), and who underwent a complete evaluation that included body composition assessment, blood measurements, and assessment of CV risk factors. Survival information was available for >99% of the subjects after a median follow-up of 8.8 years. We divided our sample using sex-specific tertiles of BF%. The highest tertile of BF (>23.1% in men and >33.3% in women) was labelled as NWO. When compared with the low BF group, the prevalence of metabolic syndrome in subjects with NWO was four-fold higher (16.6 vs. 4.8%, P < 0.0001). Subjects with NWO also had higher prevalence of dyslipidaemia, hypertension (men), and CV disease (women). After adjustment, women with NWO showed a significant 2.2-fold increased risk for CV mortality (HR = 2.2; 95% CI, 1.03-4.67) in comparison to the low BF group. Normal weight obesity, defined as the combination of normal BMI and high BF content, is associated with a high prevalence of cardiometabolic dysregulation, metabolic syndrome, and CV risk factors. In women, NWO is independently associated with increased risk for CV mortality.
Highlights
The prevalence of obesity in the USA has risen remarkably over the past four decades, increasing from 13% in the 60s, to over 30% in the most recent analyses of the National Health and Nutrition Examination Surveys (NHANES).[1,2,3] the gold standard definition of obesity is considered an excess in body fat (BF),[4] clinicians and epidemiologists usually rely on body mass index (BMI) as a means of defining the presence of adiposity or obesity
We analysed 6171 subjects .20 years of age from the Third National Health and Nutrition Examination Survey (NHANES III) and the NHANES III mortality study, whose BMI was within the normal range (18.5–24.9 kg/m2), and who underwent a complete evaluation that included body composition assessment, blood measurements, and assessment of CV risk factors
The gold standard definition of obesity is considered an excess in body fat (BF),[4] clinicians and epidemiologists usually rely on body mass index (BMI) as a means of defining the presence of adiposity or obesity
Summary
The prevalence of obesity in the USA has risen remarkably over the past four decades, increasing from 13% in the 60s, to over 30% in the most recent analyses of the National Health and Nutrition Examination Surveys (NHANES).[1,2,3] the gold standard definition of obesity is considered an excess in body fat (BF),[4] clinicians and epidemiologists usually rely on body mass index (BMI) as a means of defining the presence of adiposity or obesity. Body mass index has shown many advantages as a surrogate of BF, such as simplicity and reproducibility, and epidemiologic studies have shown an association between extreme values of BMI and increased mortality.[5,6,7,8] a significant limitation of using BMI is its failure to differentiate between an elevated BF content and preserved or increased lean mass, especially in patients with a BMI ,30 kg/m2.9 – 15. An excess in adiposity has been clearly associated with numerous comorbidies and pathophysiologic processes, including insulin resistance, altered lipid metabolism, and endothelial dysfunction.[16] the determination of adiposity by methods more
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
