Metabolically Obese But Normal Weight Research Articles

Association between metabolically obese but normal weight and cardiovascular diseases in Korean menopausal women.

The aim of this study was to present useful data for developing effective health management strategies for cardiovascular disease (CVD) prevention in postmenopausal women by investigating health-related behaviors and the prevalence of CVD for different types of obesity classified according to metabolic health status and body mass index criteria. Using the 2016 Korean National Health and Nutrition Examination Survey VII-1 data, 1,190 menopausal women aged 50 years or older were analyzed in this cross-sectional study. The participants were divided into four groups as follows: metabolically healthy and normal weight (MHNW), metabolically obese but normal weight (MONW), metabolically healthy but obese, and metabolically obese and obese. Complex-samples general linear analysis, t tests, and logistic regression analysis were used to compare the differences in health-related behaviors and the risk of CVD among the four groups. The risk for stroke was 3.61 times higher (95% CI, 1.18-11.03) in the MONW group than in the MHNW group. We found a strong association between the MONW group of obesity and the risk for CVD, particularly stroke, in postmenopausal women. These findings would serve as valuable evidence for developing and implementing interventions to prevent stroke in postmenopausal women in the MONW group.

Metabolically obese phenotype and its dynamic change are associated with increased carotid intima-media thickness: Results from a cohort study

Background and aimsTo examine associations between metabolically obese phenotypes or their changes and increased carotid intima-media thickness (CIMT). Methods and resultsThis prospective cohort included 13,681 Chinese adults aged 20–80 years who completed follow-up health examination with carotid ultrasound and were divided according to metabolic and weight status: metabolically healthy and normal weight (MHNW); metabolically obese but normal weight (MONW); metabolically healthy but obese (MHO); metabolically abnormal and obese (MAO). Cox and logistic regression were used to evaluate the associations of the phenotypes or their changes with increased CIMT.During a mean follow-up of 33 months, 1927 participants developed increased CIMT. After adjusting for age, sex and potential biochemical confounders, MAO was significantly associated with increased CIMT (HR 1.22, 95% CI [1.07, 1.4]); the association remained significant in those 40 years or older. Compared with stable MHNW, increased CIMT risk was higher for stable MAO (OR 1.35 [1.16, 1.57]), transitional MAO from MONW (OR 1.44 [1.04, 1.97]), and transitional MHO from MHNW (OR 1.59 [1.10, 2.26]) in demographic adjusted models; only stable MAO remained significant in the multivariate adjusted model (OR 1.23 [1.05, 1.45]). ConclusionMAO significantly elevated the risk of increased CIMT. Stable MAO and obese transitions also promoted CIMT progression.

Prevalence and epidemiological determinants of metabolically obese but normal-weight in Chinese population

BackgroundThere is metabolic heterogeneity in normal-weight individuals, however, there has been limited research in the Chinese population. This study aimed to investigate the prevalence, distribution and epidemiological determinants of metabolically obese but normal-weight (MONW) in a Chinese population.MethodsA total of 17,876 normal-weight individuals were recruited from 37,815 individuals in Zhejiang province in southeastern China. Normal-weight was defined as a body mass index (BMI) of 18.5–23.9 kg/m2. Metabolically abnormal traits were assessed by metabolic syndrome criteria from the International Diabetes Federation (IDF) in 2015. MONW was defined as individuals who had at least two metabolically abnormal trait but normal weight. Multiple logistic regression was used to investigate MONW risk factors, adjusting for potential confounders.ResultsThe prevalence of metabolic abnormality was 34.1% in normal-weight individuals, and the overall prevalence of MONW was 16.1% in the general population. Different MONW distributions were found between men and women depending on age. Compared with women, men had a significantly higher MONW prevalence among those aged < 45 years old, and there was a lower prevalence for those aged ≥50 years old. Higher BMI or waist circumference (WC), central obesity, menopause, and family histories of hypertension, diabetes, and cardiovascular diseases, increased MONW risk. Higher education levels, regular alcohol drinking, and balanced or vegetarian food preferences reduced MONW risk.ConclusionsNormal-weight individuals have metabolic heterogeneity in China. The MONW distribution between men and women depends on age. BMI, WC, dietary factors, and family history of chronic diseases, are associated with metabolic status.

Parathyroid hormone and vitamin D are associated with the risk of metabolic obesity in a middle-aged and older Korean population with preserved renal function: A cross-sectional study.

BackgroundIn general, obesity is a major contributor to metabolic syndrome (MetS) and is associated with insulin resistance (IR). Metabolically obese but normal weight (MONW) individuals present metabolic abnormalities and features of MetS despite having a normal range of body mass index (BMI). In recent years, different subtypes of obesity have been introduced, including metabolically healthy obese (MHO) and metabolically obese obese (MOO). Also, it has been reported that vitamin D and parathyroid hormone (PTH) are possibly linked with MetS.Methods and findingsIn this study, we aimed to evaluate the association between serum 25(OH)D, serum PTH, and the risk of metabolic obesity in four subtypes using nationally representative survey data for a Korean population conducted between 2008 and 2010. Of the 29,235 Korean participants, 18,997 subjects aged under 50 years were excluded. Participants with diabetes (n = 1,520), renal insufficiency (glomerular filtration rate [GFR] < 45 ml/min/1.73 m2, chronic kidney disease [CKD] stage 3b, 4, and 5 according to KDOQI classification [1]) (n = 49), history of treatment for osteoporosis (n = 455), insufficient data (n = 1,613), and fasting time less than 8 hours prior to blood collection (n = 771) were excluded for analysis. Ultimately, 5,830 adults (2,582 men and 3,248 women) were eligible for the present study. And, subtypes of obesity were divided into four types: Metabolically healthy normal weight (MHNW), Metabolically healthy obese (MHO), Metabolically obese but normal weight (MONW), and Metabolically obese obese (MOO). Female subjects with metabolic obesity were more likely to have higher levels of PTH and Male subjects with metabolic health were more likely to have higher serum 25(OH)D levelsConclusionWe concluded that a positive association between serum PTH concentration and metabolic obesity among female subjects and an inverse relationship between serum 25(OH)D levels and the risk of metabolic obesity were found among male subjects. Further prospective studies are necessary to explore the biological mechanisms underlying these sex-specific findings.

Prevalence of metabolically obese but normal weight (MONW) and metabolically healthy but obese (MHO) in Chinese Beijing urban subjects.

The aim of this study was to assess the prevalence of metabolic syndrome (MetS) in non-obese adults (body mass index (BMI) < 25 kg/m2) and the prevalence of obese adults (body mass index (BMI) ≥ 25 kg/m2) without MetS in Chinese Beijing urban subjects. A cross-sectional study was conducted and the subjects who came to the hospital to receive a health examination were enrolled randomly. Regardless of age stratification, men have a higher prevalence of MetS than women. Among the urban Beijing population, prevalence of metabolically obese but normal weight (MONW) is lower than metabolically healthy but obese (MHO) regardless of gender. Except for the underweight group, participants exhibit significant differences between MetS and non-MetS subgroups in all tested variables in normal weight and overweight groups, whereas MONW and MHO participants exhibit significant differences in all variables except for creatinine (CR), aspartate aminotransferase (AST), uric acid (UAC) and high-density lipoprotein cholesterol (HDL-C). Women tend to have a higher MONW prevalence but lower MHO prevalence than men. Accordingly, MetS happens more frequently among those 40-59 yr. Besides, sex, age, WC, SBP, DBP, ALT, FG, UAC, TG, HDL-C and LDL-C are risk factors for MetS after multivariate adjustment. In conclusion, the prevalence of MONW is lower than MHO regardless of gender. Women tend to have a higher MONW prevalence but lower MHO prevalence than men.

Metabolically Obese Individuals of Normal Weight Have a High Risk of 25-Hydroxyvitamin D Deficiency

BackgroundVitamin D status is related to obesity-related metabolic disorders. We investigated the risk of 25-hydroxyvitamin D [25(OH)D] deficiency among different metabolic phenotypes. MethodsThis prospective cross-sectional study evaluated 1,292 individuals who were ≥40 years old. Participants were classified as metabolically healthy and normal weight (MHNW), metabolically obese but normal weight (MONW), metabolically healthy but obese (MHO) or metabolically unhealthy and obese (MUO). The demographic and clinical characteristics, as well as plasma 25(OH)D levels, were compared between the 4 groups. ResultsThe prevalences of MHNW, MONW, MHO and MUO were 32.1%, 19.3%, 17.9% and 30.7%, respectively. Approximately 58.5% participants had vitamin D deficiency, and vitamin D deficiency was more common in the MONW (68.7%) and MUO (73.6%) groups (MHNW, 42.7 and MHO, 50.2%). The MONW and MUO groups had lower 25(OH)D levels (versus the MHNW and the MHO groups). Among vitamin D-deficient participants, the MONW group exhibited increased risks of abdominal obesity (odds ratio [OR]: 3.28, P = 0.005), hypertension (OR: 3.08, P = 0.003) and elevated C-reactive protein (OR: 1.97, P = 0.03). In addition, the MUO group exhibited increased risks of hypertriglyceridemia (OR: 2.57, P = 0.001), insulin resistance (OR: 2.37, P = 0.001) and elevated C-reactive protein level (OR: 2.09, P = 0.003). ConclusionsIndividuals who were MONW and MUO had increased risks of vitamin D deficiency (versus MHNW and MHO), and individuals with vitamin D deficiency had worse metabolic status. Vitamin D supplementation may improve the metabolic status of individuals who are MONW or MUO.

The normal-weight type 2 diabetes phenotype revisited

BackgroundType 2 diabetes (T2DM) is associated with obesity, insulin resistance and the metabolic syndrome (MetS). In non-diabetic populations, features of metabolic obesity (MO) are observed in a minority of normal-weight (NW) subjects. The cardiometabolic status of metabolically obese but normal-weight (MONW) individuals has not yet been phenotyped in T2DM. Patients and methodsPrevalence and features of MONW were analyzed in 1244 T2DM patients, in whom MONW was identified as a BMI <25.0 and a MetS score ≥3/5. Among NW (n=262; 21%), those without MetS (n=152; NW-MetS[−]) were compared to NW-MetS[+] (n=110; i.e. 42% of NW and 9% of all T2DM). ResultsThere were no differences between groups in age; gender; diabetes duration; smoking; BP; and LDL-C. NW-MetS[+] had higher BMI; waist; fat mass; visceral fat; liver steatosis and HbA1c, and lower insulin sensitivity. Non-right-handedness was twice-higher (18%) in NW-MetS[−]. NW-MetS[+] had higher apoB100 and triglycerides, and lower HDL-C and LDL size. Macroangiopathy was present in 39% of NW-MetS[+] vs. 22% of NW-MetS[−], as coronary (23% vs. 14%) or peripheral artery disease (14% vs. 5%) and TIA/stroke (15% vs. 7%). Microangiopathy was present in 54% of NW-MetS[+] vs. 32% of NW-MetS[−], as retinopathy (25% vs. 13%); neuropathy (29% vs. 18%); and albuminuria (39% vs. 20%). ConclusionsMONW among T2DM represents a significant minority (about 1 in 10). Their cardiometabolic phenotype deserves attention due to multiple comorbidities, including a twice-higher prevalence of micro-/macrovascular damage in patients wrongly perceived at lower risk due to normal BMI. Unexpectedly, non-right-handedness was over-represented among metabolically healthy patients.

Prevalence of Metabolically Healthy Obese and Metabolically Obese but Normal Weight in Adults Worldwide: A Meta-Analysis.

The objective of the present study was to summarize the prevalence and influencing factors of metabolically healthy obese (MHO) and metabolically obese but normal weight (MONW) among people ≥ 18 years old in the general population worldwide. We searched for studies of the prevalence of MHO and MONW published in English and Chinese up to October 2013. Pooled prevalence estimates were calculated by a random-effects model according to a Q test. The effects of gender, region, age, sample size, smoking, and alcohol consumption on MHO and MONW were analyzed. Differences between subgroups were assessed by chi-square test. Publication bias was estimated by Egger's test. Studies of MHO and MONW showed heterogeneity (I(2)=99.4% and I(2)=99.7%, respectively). The overall prevalence of MHO and MONW was 7.27% (95% CI 5.92-8.90%) and 19.98% (95% CI 16.54-23.94%), respectively. American populations had the highest MHO prevalence and European populations the highest MONW prevalence. Different patterns of MHO and MONW were observed in the subgroup analysis with respect to gender, age, sample size, smoking, alcohol consumption, and metabolically healthy criteria. The prevalence of both MHO and MONW were affected by gender, region, age, sample size, smoking, alcohol consumption, and metabolically healthy criteria, but studies showed high heterogeneity.

Association between thyroid hormones, thyroid antibodies and insulin resistance in euthyroid individuals: A population-based cohort

AimThe association between insulin resistance and thyroid function in euthyroid subjects has not yet been clarified. This study aimed to investigate the association between thyroid function within the normal reference range and insulin resistance in participants of the Tehran Thyroid Study (TTS). MethodsThis cross-sectional study was conducted within the framework of the TTS. Of 5786subjects aged≥20 years, 2758euthyroid subjects free of thyroid disorders, diabetes, chronic kidney disease and cardiovascular disease, and not taking steroids and lipid-lowering agents, were included. Serum concentrations of free thyroxine (FT4) and TSH were measured. The homoeostasis model assessment index for insulin resistance (HOMA-IR) was used to evaluate IR. ResultsOn linear regression analysis, a negative association was found between serum FT4 levels and HOMA-IR in the model with age, smoking and physical activity (B=−0.09, P<0.001) and in the WC-adjusted model with age, smoking and physical activity for men (B=−0.06, P<0.01). In addition, there was a positive association between serum TSH levels and HOMA-IR in both models [with age, smoking and physical activity (B=0.07, P=0.006), and age, smoking, physical activity and adjusted for WC (B=0.05, P=0.01)] that was not more significant on logistic regression analysis. In women, neither serum FT4 nor TSH levels were associated with HOMA-IR; the prevalence of IR decreased from 27.2 to 19.1 with increasing tertiles of FT4 only in men (P=0.01). No significant differences were observed in HOMA-IR and its components between thyroid peroxidase antibody (TPOAb)-negative and -positive groups. Also, it was found that metabolically healthy but obese (MHO) subjects had higher levels of TSH than individuals who were MONW (metabolically obese but normal weight; P<0.01). ConclusionLow FT4 was independently associated with IR in healthy euthyroid Iranian men.

Association of metabolic syndrome components with insulin resistance in normal weight population: the Qazvin Metabolic Diseases study

Metabolically obese but normal weight (MONW) is associated with higher risk of type 2 diabetes, dyslipidemia, and hypertension. The aim of this study was to evaluate the association of metabolic syndrome components with MONW in each sex in Iranian population. This cross-sectional study was performed on 417 normal weight subjects in Qazvin, Iran between September 2010 and April 2011. MONW was defined by insulin resistance (IR) using the homeostatic model assessment (HOMA). Cut off point for IR was defined as the lower limit of top quintile of HOMA-IR values in normal weight population without any metabolic risk factors. Data were analyzed using T test, Mann-Whitney U test, and multi-variant logistic regression analysis. Of 417 subjects, 44.3% were female. The prevalence of MONW was 33.8% in men and 39.8% in women. Triglycerides levels were significantly higher in both men and women with MONW. Waist circumference was significantly higher in men with MONW, while high-density lipoprotein cholesterol levels were significantly lower in women with MONW. In logistic regression analysis, hypertriglyceridemia in women (OR 3.398; 95% CI 1.306-8.846) and waist circumference (per 5cm increment) in men (OR 1.653; 95% CI 1.279-2.136) had independent association with MONW. Association of metabolic syndrome components with MONW is different in men and women. Waist circumference had an independent association with IR in men but not in women. IR and its complications should be considered in lean women with hypertriglyceridemia.

A novel criterion for identifying metabolically obese but normal weight individuals using the product of triglycerides and glucose.

Objectives:Metabolically obese but normal weight (MONW) individuals constitute a subgroup of normal weight individuals that display impaired insulin sensitivity with a higher risk of developing diabetes, cardiovascular disease and mortality. We aimed to propose a novel criterion for defining MONW by examining the usefulness and the cutoff value of the TyG index, a product of the levels of triglycerides and glucose, in identifying MONW individuals. In addition, the performance of this criterion in predicting the future incidence of diabetes was assessed.Subjects/methods:A total of 7541 non-diabetic, normal weight (body mass index ⩾18.5 and <25 kg m−2) subjects were selected from the Korea National Health and Nutrition Examination Survey conducted in 2009–2010. Another 3185 participants with follow-up studies were selected from a prospective community-based cohort study. The TyG index was calculated as ln(fasting triglycerides (mg dl−1) × fasting glucose (mg dl−1)/2).Results:The levels of the TyG index paralleled the prevalence of metabolic syndrome and its components. The cutoff value of the TyG index that reflected MONW based on the receiver operating characteristics analysis was 8.82 for men and 8.73 for women, with the area under the curve values being 0.855 and 0.868, respectively. The sensitivity and the specificity were 84.2 and 77.6% in men and 69.1 and 89.4% in women, respectively. Individuals designated as MONW, who have a normal weight and TyG levels higher than cutoff, displayed a metabolically unhealthy phenotype and an approximately twofold higher risk of developing diabetes compared with metabolically healthy normal weight subjects.Conclusions:We propose a simple diagnostic criterion of MONW, which might be used to discriminate subjects with a higher risk of metabolic diseases.

Identifying subgroups of obesity using the product of triglycerides and glucose: the Korea National Health and Nutrition Examination Survey, 2008-2010.

To determine whether the TyG index, a product of the levels of triglycerides and glucose, may be a valuable marker for identifying metabolically obese but normal weight (MONW) or metabolically healthy but obese (MHO) individuals. A total of 17 029 nondiabetic subjects (7185 men and 9844 women) were selected from the Korea National Health and Nutrition Examination Survey conducted in 2008-2010. Individuals with a normal body mass index (BMI) (≥18·5 and <23 kg/m(2) ) and the highest quartile of the homoeostasis model assessment of insulin resistance (HOMA-IR) were classified as MONW. Individuals with obesity (BMI ≥25 kg/m(2) ) and the lowest quartile of HOMA-IR were classified as MHO. The TyG index was calculated as ln[fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. The levels of the TyG index paralleled with various metabolic risk parameters. The index was significantly higher in the MONW group and lower in the MHO group when compared with the non-MONW group and the non-MHO group, respectively. The odds ratios (ORs) of being categorized into the MONW group were approximately fourfold higher in the highest vs lowest quartiles of the TyG index (3·999: 95% CI, 2·508-6·376 in men; 4·737: 95% CI, 3·418-6·565 in women) among normal weight subjects. Conversely, there was a stepwise decrease in the OR of being categorized into the MHO group across the TyG index quartiles among obese subjects. These data highlight the value of the TyG index in discriminating those subjects with higher risks of metabolic diseases.

It is time to define metabolically obese but normal‐weight (MONW) individuals

It is time to define metabolically obese but normal‐weight (<scp>MONW</scp>) individuals

Metabolically obese status with normal weight is associated with both the prevalence and severity of angiographic coronary artery disease

ObjectiveWe evaluated prevalence and severity of angiographic coronary artery disease (CAD) according to groups by metabolically obese (MO) and/or weight status. Material/methodsNormal weight was defined as body mass index (BMI, kg/m2)<25 and obesity was defined as BMI≥25. The MO was determined using the National Cholesterol Education Program-Adult Treatment Panel III classification with Korean-specific cutoffs for abdominal obesity. Therefore, a total of 856 subjects were categorized as follows: (1) metabolically healthy and normal weight (MHNW); (2) metabolically obese but normal weight (MONW); (3) metabolically healthy but obese (MHO); and (4) metabolically abnormally obese (MAO). The presence of obstructive lesion≥50% of coronary artery was considered as an angiographic CAD and the Gensini scoring system was used for the severity. ResultsMONW or MO showed a higher prevalence of CAD than MHNW or non-MO after adjustment for age and sex, respectively (MONW, odds ratio [OR]=1.69, 95% confidence interval [CI]: 1.13–2.51 and MO, OR=1.44, 95% CI: 1.09–1.91). In subjects without diabetes mellitus (DM), MONW or MO showed a marginally higher prevalence of CAD (MONW, OR=1.58, 95% CI: 0.96–2.61 and MO, OR=1.41, 95% CI: 0.96–2.08). MONW was independently associated with a higher severity of angiographic CAD than MHNW after age, sex, glomerular filtration rate, smoking status, high sensitive C-reactive protein, and use of anti-platelet and anti-angina drugs (β=0.118, P=0.005). And MO was associated with a higher severity of angiographic CAD than non-MO after adjustment for age and sex (β=0.077, P=0.024). The above associations were also consistent in subjects without DM (MONW, β=0.147, P=0.003 and MO, β=0.129, P=0.005). ConclusionsMONW or MO is associated with both the prevalence and severity of angiographic CAD after adjustment for age and sex and MONW is independently associated with the severity of angiographic CAD irrespective of DM. Therefore, subjects with MO but normal weight (MONW) should be carefully examined for angiographic CAD.

MONW Phenotype Is Associated With Advanced Colorectal Adenoma in Korean Men

The aim of this study was to investigate whether there was a relationship between colorectal adenoma and metabolically obese but normal weight (MONW) among Korean men and women. The MONW phenotype is defined as a BMI <25, but fulfilling the metabolic syndrome (MS) criteria with a modified waist circumference (≥90 cm for men and ≥85 cm for women) appropriate for Korean. A total of 3,430 subjects (2,263 men and 1,167 women; 23-75 years old) were included in the study. Colorectal adenomas were diagnosed in 775 men and 199 women. The rate of advanced adenomas in males was 24.3% and in females 21.1%. A significant association between MONW and advanced colorectal adenoma was found in men (age-adjusted odds ratio (OR) = 1.92, 95% confidence interval (CI): 1.06-3.47) but not in women (age-adjusted OR = 1.80, 95% CI: 0.50-6.45). The findings suggest that men with MONW may have an increased risk of developing advanced colorectal adenoma whereas this does not seem true for females.

Modified high-sucrose diet-induced abdominally obese and normal-weight rats developed high plasma free fatty acid and insulin resistance.

Introduction. Metabolically obese but normal-weight (MONW) individuals have metabolic features of overt obesity, and abdominal adiposity is common in them. Animal models of MONW individuals are lacking. We aimed to develop an abdominally obese and normal-weight (AONW) rat model. Methods and Results. Young male Sprague-Dawley rats were fed chow or a modified high-sucrose (HS) diet for 20 weeks. The HS diet induced increased visceral adipose tissue without increased body weight, reduced glucose disposal rates, and increased hepatic glucose output during the hyperinsulinemic-euglycemic clamp, increased plasma glucose during the intraperitoneal glucose tolerance test, and increased plasma free fatty acids. Hepatic lipidosis and hepatocyte mitochondria swelling were found in HS rats through light microscopy and transmission electron microscopy; similar impairments were not observed in muscle. RT-PCR showed that mRNA expression of uncoupling protein 3 and peroxisome proliferator-activated receptor-gamma coactivator 1α increased in muscle of HS rats, while expression of mitochondrial transcription factor A, glucose transporter type 4, and insulin receptor substrate-1 did not change significantly. Conclusion. AONW rats developed metabolic disorders seen in MONW individuals. Steatosis, mitochondrial morphologic changes, and insulin resistance were more serious in liver than in muscle. Genes involved in fatty acid metabolism and mitochondrial function changed in less impaired muscle.

Identifying metabolically obese but normal‐weight (MONW) individuals in a nondiabetic Korean population: the Chungju Metabolic disease Cohort (CMC) study

To investigate the prevalence and identify the phenotype of individuals suspected to be metabolically obese but normal weight (MONW). Eight thousand nine hundred and eighty-seven nondiabetic subjects aged over 40 years were selected from the Chungju Metabolic disease Cohort study performed in 2003-2006 in Korea. Those within the highest quartile in the homeostasis model assessment of insulin resistance (HOMA-IR) with a normal body mass index (BMI) between 18·5 and 23 kg/m(2) were classified as MONW. Data on anthropometry, lipid profiles and HOMA-IR values were analysed. The prevalence of MONW was 14·2% for men and 12·9% for women amongst normal-weight subjects. Multiple logistic regression analysis showed that total cholesterol (TC) levels over 5·17 mm (odds ratio, OR = 1·481; 95% confidence intervals, CI 1·086-2·021), triglyceride (TG) levels over 1·69 mm (OR = 1·507; 95% CI 1·093-2·077) and high-density lipoprotein-cholesterol levels lower than 1·03 mm (OR = 1·580; 95% CI 1·053-2·371) independently had higher odds of diagnosing MONW amongst men. For women, a BMI over 21·5 kg/m(2) (OR = 1·405; 95% CI 1·034-1·909), TC levels over 5·17 mm (OR = 1·524; 95% CI 1·112-2·090) and TG levels over 1·69 mm (OR = 1·799; 95% CI 1·302-2·487) were independently associated with a diagnosis of MONW. More than 10% of normal-weight subjects were classed as MONW in this cohort. Identification of these subjects based on lipid profiles could aid in the early detection of a high risk group of developing cardiometabolic diseases.

Phenotypic characteristics in metabolically obese but normal weight non-diabetic patients with schizophrenia

Background A unique group of individuals termed metabolically obese but normal weight (MONW) has been identified in the general population. The present study examined phenotypic characteristics of MONW individuals in a sample of normal weight, non-diabetic patients with schizophrenia. Methods Outpatients 19 to 75 years old diagnosed with schizophrenia or schizoaffective disorder participated in a multi-center, cross-sectional study. Those with normal weight (body-mass-index (BMI) < 25 kg/m 2) were included in the present analysis. Patients were further defined as MONW or metabolically nonobese based on a cut-off value of the homeostasis model assessment of insulin resistance (HOMA-IR = 1.86). Fasting blood samples were collected to determine levels of various metabolic parameters. In addition, lipoprotein subclass concentrations and sizes were analyzed using nuclear magnetic resonance (NMR) spectroscopy. Results Seventeen MONW individuals and 17 metabolically nonobese individuals matched by BMI and gender were identified from a study sample of 206 patients with schizophrenia. There were no significant differences between the two groups on anthropometric measures (waist circumference and waist/hip ratio, ps > 0.3). However, the MONW group had significantly higher levels of intermediate VLDL particle and Apolipoprotein B, and significantly lower levels of large HDL particle compared with the metabolically nonobese group (p = 0.012, p = 0.036 and p = 0.041 respectively). Conclusion The MONW individuals in non-diabetic schizophrenia patients seem to have an unfavorable metabolic profile and significant atherogenecity. Clinicians should be vigilant about the risk of cardiometabolic comorbidity even when the patient' body weight is normal.

Abstract: P1303 METABOLICALLY OBESE PATIENTS WITH NORMAL WEIGHT HAVE GREATER DEGREE OF CARDIOVASCULAR RISKS THAN METABOLICALLY HEALTHY BUT OBESE PATIENTS

A unique group of individuals termed metabolically obese but normal weight (MONW) has been identified in the general population. The present study examined phenotypic characteristics of MONW individuals in a sample of normal weight, non-diabetic patients with schizophrenia.Outpatients 19 to 75 years old diagnosed with schizophrenia or schizoaffective disorder participated in a multi-center, cross-sectional study. Those with normal weight (body-mass-index (BMI) < 25 kg/m2) were included in the present analysis. Patients were further defined as MONW or metabolically nonobese based on a cut-off value of the homeostasis model assessment of insulin resistance (HOMA-IR = 1.86). Fasting blood samples were collected to determine levels of various metabolic parameters. In addition, lipoprotein subclass concentrations and sizes were analyzed using nuclear magnetic resonance (NMR) spectroscopy.Seventeen MONW individuals and 17 metabolically nonobese individuals matched by BMI and gender were identified from a study sample of 206 patients with schizophrenia. There were no significant differences between the two groups on anthropometric measures (waist circumference and waist/hip ratio, ps > 0.3). However, the MONW group had significantly higher levels of intermediate VLDL particle and Apolipoprotein B, and significantly lower levels of large HDL particle compared with the metabolically nonobese group (p = 0.012, p = 0.036 and p = 0.041 respectively).The MONW individuals in non-diabetic schizophrenia patients seem to have an unfavorable metabolic profile and significant atherogenecity. Clinicians should be vigilant about the risk of cardiometabolic comorbidity even when the patient' body weight is normal.

Metabolically obese but normal weight (MONW) and metabolically healthy but obese (MHO) phenotypes in Koreans: characteristics and health behaviors.

The purpose of this study was to estimate the prevalence of 'metabolically obese, but normal-weight' (MONW) and 'metabolically healthy, but obese' (MHO) phenotypes in Korean adults and identify the characteristics and health behaviors related to both phenotypes. Of the 5267 participants (2227 men, 3040 women) from the 3rd Korean National Health and Nutrition Examination Survey, the MONW phenotype (8.7% of total subjects, 12.7% of normal-weight subjects) was defined as individuals of normal weight (BMI<25) with the metabolic syndrome (MS), and the MHO phenotype (15.2% of total subjects, 47.9% of obese subject) was defined as obese individuals (BMI>or=25) without the MS. The odds ratio for MONW phenotype was significantly higher for those at older age, those with lower education, those who had moderate alcohol consumption, and time spent participating in moderate-intensity exercise. The odds ratio for MHO phenotype was significantly lower for those at older age, men, those with lower education, and former/current smokers. In conclusion, regardless of weight status, health behaviors should be modified to prevent MS.