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.
Highlights
Excessive body fat increases the risk of other non-communicable diseases (NCD), such as cardiovascular disease (CVD), chronic respiratory disease, metabolic disorders, and certain types of malignant neoplasms [1,2]
Low HDL-cholesterol was significantly higher in women (67.5%) than in men (50.1%), whereas high blood pressure was higher in men (35.0%) compared with women (12.4%)
High Waist-to-height ratio (WtHR), waist circumference (WC), fat mass index, the ratio of fat mass to fat free mass, the ratio of fat mass to handgrip strength, the ratio of handgrip strength to fat free mass, the normalized as handgrip strength (NGS) to visceral fat level ratio, glycemia, triglycerides, cardiometabolic risk Z-score (+1 standard deviation (SD) above the mean), alcohol intake, or smoking did not differ by sex
Summary
Excessive body fat increases the risk of other non-communicable diseases (NCD), such as cardiovascular disease (CVD), chronic respiratory disease, metabolic disorders, and certain types of malignant neoplasms [1,2]. The World Health Organization (WHO) defines obesity as excessive body fat accumulation, which is associated with several risks to health [1]. The body mass index (BMI), is used as a surrogate marker for body fat and for classifying obesity, is positively associated with risk factors for cardiovascular and metabolic diseases when BMI is above 18.5 kg/m2 [4]. BMI is not a very accurate measurement for estimate adiposity in a particular individual since BMI does not take body composition (i.e., fat-free mass vs adipose tissue) into account. An individual with healthy BMI (18.5–24.9 kg/m2 ) may have either an appropriate body fat percentage or an excessive body fat accumulation that might be masked by the normal BMI [5]
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