The association between body composition and metabolically unhealthy profile of adults with normal weight in Northwest China.

Ling Fan,Jiangwei Qiu,Xiaoxia Li,Yuhong Zhang,Lan Liu,Yi Zhao,Qingan Wang,Jiaxing Zhang,Xiuying Liu,Yu Zhao,Ting Yin,Faxuan Wang,Jinyun Jing,Clemens Fürnsinn

doi:10.1371/journal.pone.0248782

Abstract

ObjectiveRelated evidences of metabolically unhealthy profile of adults with normal weight are not well characterized in the Chinese population. This is because they cannot be effectively identified by regular measurements (such as body mass index [BMI]). To overcome this gap in literature, this study aimed at investigating the association between body composition and metabolically unhealthy profile in Chinese adults with normal weight.MethodsA total of 5427 individuals with normal-weight were recruited from 15820 people living in Ningxia Hui Autonomous Region in Northwest China. Normal-weight was defined as a BMI of 18.5–23.9 kg/m2. Metabolically unhealthy profile was assessed by the National Cholesterol Education Program Adult Treatment Panel III (ATP III). Metabolically unhealthy normal-weight (MUHNW) profile was defined in individuals who had normal weight and at least two cardiometabolic risk factors. Generalized linear model was used to investigate the association between body composition measured by bioelectrical impedance and metabolically unhealthy profile in adults with normal-weight.ResultsThe percentage of metabolically unhealthy profile was 35.86% in adults with normal weight. Different MUHNW distributions were found between males and females depending on age. The percentage of the MUHNW profile significantly increased in women after the age of 55, contrary to men. The association between body composition and MUHNW was affected by age and sex. The increased adiposity indices (fat mass index [FMI], visceral fat level [VFL], waist circumference [WCF]), and reduced skeletal muscle mass ratio [SMR] showed significant differences between MUHNW and metabolically healthy with normal weight (MHNW) (p < 0.05).ConclusionThe distribution of MUHNW differed between ages and sexes. FMI, VFL, WCF and SMR could be responsible for the MUHNW adults, providing a new insight into the potential metabolic risks for the adults with normal weight in China. This directs us in the management of the MUHNW for their early prevention.

Highlights

With the development of economies, high-nutrient diets have caused a considerable increase of the prevalence of obesity worldwide
The percentage of the metabolically unhealthy normal-weight (MUHNW) profile significantly increased in women after the age of 55, contrary to men
Our results suggested that FMI, visceral fat level (VFL) and WCR were the risk factors of increased MUHNW risk, and SMR was a protective factor of increased MUHNW risk

Summary

Introduction

With the development of economies, high-nutrient diets have caused a considerable increase of the prevalence of obesity worldwide. Most obese individuals have an increased risk for cardiometabolic diseases, such as hypertension, dyslipidemia, diabetes, and cardiovascular disease. The increased obesity imposes a heavy social burden and has gained public health concerns recently [3]. Individuals in the normal BMI range may display metabolically unhealthy profile associated with obesity [4]. Ruderman et al [5] summarized that individuals with normal weight (or BMI), but like people with obesity, have hyperinsulinemia, insulin-resistance, and predisposed to type 2 diabetes, hypertriglyceridemia, and premature coronary heart disease. It is difficult to identify the individuals with normal weight who are metabolically unhealthy by using BMI measurements. Some individuals with normal weight have a metabolically unhealthy profile worldwide. The metabolically unhealthy normal-weight (MUHNW) phenomenon was reported widespread and serious in Asian countries

Methods

Results

Discussion

Conclusion