Normal-weight obesity is associated with increased risk of subclinical atherosclerosis

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.

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Expanded normal weight obesity and blood pressure in Chinese adults: a community-based cross-sectional study

Australian Journal of Primary Health ◽

10.1071/py18166 ◽

2019 ◽

Vol 25 (3) ◽

pp. 256 ◽

Cited By ~ 2

Author(s):

Huijing He ◽

Li Pan ◽

Feng Liu ◽

Jingang Ma ◽

Zhiping Hu ◽

...

Keyword(s):

Blood Pressure ◽

Body Fat ◽

Normal Weight ◽

Shaanxi Province ◽

High Risk Population ◽

Body Fat Percentage ◽

Fat Percentage ◽

Cross Sectional ◽

Increased Risk ◽

Normal Weight Obesity

The study aimed to explore the independent association between expanded normal weight obesity categories and blood pressure among adults aged 20–80 years in China. By cross-sectional design, a total of 4279 adults living in Shaanxi Province, China, were selected from communities via multi-stage stratified cluster sampling in 2014. Information on anthropometric, body composition and blood pressure was collected and analysed. Expanded normal weight obesity (ENWO) categories were used to identify the level of bodyweight based on the combination of body mass index (BMI) and body fat percentage (BFP) categories. The age- and sex-standardised prevalence of hypertension increased within ENWO groups, from 10.12% in the underweight-low body fat group to 45.92% in the obesity-high body fat group. In under or normal weight participants, body fat percentage was found independently associated with hypertension in men, with an adjusted odds ratio of 3.69 in the fourth quartile of BFP compared with the first one. However, this effect was not observed in women. BFP was independently associated with increased risk of hypertension, especially in men. People with normal BMI should be re-identified as a high-risk population based on BFP level when it comes to hypertension prevention in primary healthcare settings.

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Characterization of Gut Microbiota Composition in Hemodialysis Patients With Normal Weight Obesity

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa166 ◽

2020 ◽

Vol 105 (6) ◽

pp. 2006-2014 ◽

Cited By ~ 1

Author(s):

Ting-Yun Lin ◽

Ping-Hsun Wu ◽

Yi-Ting Lin ◽

Szu-Chun Hung

Keyword(s):

Gut Microbiota ◽

Hemodialysis Patients ◽

Normal Weight ◽

Normal Body Mass Index ◽

Fat Percentage ◽

Β Diversity ◽

Α Diversity ◽

Increased Risk ◽

Normal Weight Obesity ◽

Underlying Mechanisms

Abstract Background Normal weight obesity (NWO), defined by a normal body mass index (BMI) but increased body fat percentage (BF%), is associated with an increased risk of cardiovascular disease and mortality. NWO is characterized by inflammation and muscle wasting in chronic kidney disease (CKD), but the underlying mechanisms remain largely unknown. Gut microbiota has been implicated in the regulation of host metabolism and may play important roles in the development of NWO in CKD. Methods In this case-control study, we examined the gut microbial diversity and taxonomy in 96 hemodialysis patients with normal weight (BMI < 25 kg/m2 and BF% ≤ 25% for men or ≤ 35% for women; n = 32), NWO (BMI < 25 kg/m2 and BF% > 25% for men or > 35% for women; n = 32), and overweight/obesity (BMI ≥ 25 kg/m2; n = 32), matched for age, gender, and diabetes. BF% was measured using bioimpedance spectroscopy device. Gut microbiota was determined by 16S rRNA sequencing. Results We found that α-diversity was significantly different among the 3 adiposity phenotypes, with NWO being the least diverse. α-diversity was positively correlated with BMI, subjective global assessment score, and physical activity, but negatively correlated with interleukin-6 and tumor necrosis factor-α. Patients with or without NWO were distinguished with respect to principal coordinate analysis of β-diversity. Notably, the relative abundance of butyrate-producing bacteria, such as Faecalibacterium prausnitzii and Coprococcus, was markedly reduced in patients with NWO. Conclusion Our findings support associations between gut dysbiosis and a proinflammatory and catabolic state in hemodialysis patients with NWO.

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Normal weight obesity and the risk of diabetes in Chinese people: a 9-year population-based cohort study

Scientific Reports ◽

10.1038/s41598-021-85573-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Shaoyong Xu ◽

Jie Ming ◽

Aihua Jia ◽

Xinwen Yu ◽

Jing Cai ◽

...

Keyword(s):

Cohort Study ◽

Cox Regression ◽

Population Based ◽

Incidence Rates ◽

Normal Weight ◽

Chinese People ◽

Fat Percentage ◽

Increased Risk ◽

Electrical Bioimpedance ◽

Normal Weight Obesity

AbstractWe evaluated the risk of developing diabetes in Chinese individuals with normal weight obesity (NWO). This 9-year population-based cohort study was based on the China National Diabetes and Metabolic Disorders Survey. A total of 1128 subjects without diabetes were included. Body fat percentage (BF%) was assessed by electrical bioimpedance. NWO was defined as subjects with a normal BMI (< 24 kg/m2) and an excess BF% (≥ 24% in men; ≥ 33% in women). Of 1128 individuals, 528 individuals were normal weight non-obese (NWNO), 118 (10.5%) were normal weight obese (NWO), 63 were overweight non-obese (OWNO), and 419 were overweight obese (OWO). During a follow-up of 9.0 years (interquartile range: 8.9–9.3), 113 (10.0%) individuals developed diabetes. The incidence rates of diabetes in NWNO, NWO, OWNO and OWO people were 5.69 (27 cases), 11.30 (12 cases), 3.53 (2 cases) and 19.09 (72 cases) per 1000 person-years, respectively. Cox regression analyses indicated multivariate-adjusted hazard ratios of diabetes in NWO, OWNO and OWO people were 2.110 (95% CI 1.026–4.337, p = 0.025), 0.441 (95% CI 0.101–1.928, p = 0.232) and 3.465 (95% CI 2.163–5.551, p < 0.001), respectively, relative to NWNO people. Chinese people with NWO are at increased risk of developing diabetes. We strongly suggest the incorporation of BF% measurement into the regular physical examination in Chinese medical practice.

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Relationship of Circulating Fetuin-A Levels with Body Size and Metabolic Phenotypes

International Journal of Endocrinology ◽

10.1155/2018/7918714 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Hye Soo Chung ◽

Hyun Jung Lee ◽

Soon Young Hwang ◽

Ju-Hee Choi ◽

Hye Jin Yoo ◽

...

Keyword(s):

Body Size ◽

Subclinical Atherosclerosis ◽

Multiple Logistic Regression Analysis ◽

Normal Weight ◽

Metabolic Health ◽

Fetuin A ◽

Nonalcoholic Fatty Liver ◽

Increased Risk ◽

Metabolically Healthy ◽

Risk Parameters

Background. Previous studies have suggested the existence of distinct body size subgroups according to metabolic health referred to as metabolically healthy obesity (MHO) and metabolically abnormal but normal weight (MANW) patients. Although nonalcoholic fatty liver disease (NAFLD) is strongly associated with obesity and metabolic syndrome, the relationship between these phenotypes and fetuin-A, a representative hepatokine, has not been explored. Methods. We examined the association between circulating fetuin-A levels, metabolic health phenotypes, cardiometabolic risk parameters, and subclinical atherosclerosis in 290 subjects who were randomly selected from an ongoing cohort study. Results. Fetuin-A concentrations were significantly associated with detrimental anthropometric and laboratory measurements, including increased waist circumference, blood pressure, alanine aminotransferase, fasting plasma glucose, and triglyceride levels. Furthermore, fetuin-A levels were significantly increased in the metabolically abnormal (MA) group compared to the metabolically healthy (MH) group in subjects without obesity (717.1 [632.1, 769.7] vs. 599.5 [502.0, 709.3], P=0.001) and subjects with obesity (704.1 [595.5-880.9] vs. 612.2 [547.9-802.1], P=0.016). In addition, brachial-ankle pulse wave velocity (baPWV), which reflects arterial stiffness, was higher in MA individuals compared to MH individuals. Multiple logistic regression analysis revealed that both individuals without obesity (P for trend = 0.017) and with obesity (P for trend = 0.028) in the higher tertiles of fetuin-A had an increased risk of MA than those in the lowest tertile. Conclusions. This study demonstrates that fetuin-A levels are significantly associated with metabolic health phenotypes, such as MHO and MANW, in Korean adults.

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Normal-Weight Obesity: A Novel CVD Risk Factor

Family Practice News ◽

10.1016/s0300-7073(08)70519-x ◽

2008 ◽

Vol 38 (7) ◽

pp. 9

Author(s):

BRUCE JANCIN

Keyword(s):

Risk Factor ◽

Normal Weight ◽

Cvd Risk ◽

Normal Weight Obesity

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Cardiovascular Complications in Patients with Klinefelter’s Syndrome

Current Pharmaceutical Design ◽

10.2174/1381612826666201102105408 ◽

2020 ◽

Vol 26 (43) ◽

pp. 5556-5563

Author(s):

Franz Sesti ◽

Riccardo Pofi ◽

Carlotta Pozza ◽

Marianna Minnetti ◽

Daniele Gianfrilli ◽

...

Keyword(s):

Metabolic Syndrome ◽

Klinefelter Syndrome ◽

Subclinical Atherosclerosis ◽

Cardiovascular Complications ◽

High Risk Population ◽

Metabolic Disturbances ◽

Future Studies ◽

Increased Risk ◽

Chromosome Disorder

More than 70 years have passed since the first description of Klinefelter Syndrome (KS), the most frequent chromosome disorder causing male infertility and hypogonadism. KS is associated with increased cardiovascular (CV) mortality due to several comorbidities, including hypogonadism, as well as metabolic syndrome and type 2 diabetes, which are highly prevalent in these patients. Aside from metabolic disturbances, patients with KS suffer from both acquired and congenital CV abnormalities, cerebrovascular thromboembolic disease, subclinical atherosclerosis and endothelial dysfunction, which may all contribute to increased CV mortality. The mechanisms involved in this increased risk of CV morbidity and mortality are not entirely understood. More research is needed to better characterise the CV manifestations, elucidate the pathophysiological mechanisms and define the contribution of testosterone replacement to restoring CV health in KS patients. This review explores the complex association between KS, metabolic syndrome and CV risk in order to plan future studies and improve strategies to reduce mortality in this high-risk population.

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Increased risk of subclinical atherosclerosis and metabolic syndrome in patients with vitiligo: a real association or a coincidence?

Dermatologic Therapy ◽

10.1111/dth.14803 ◽

2021 ◽

Author(s):

Nastaran Namazi ◽

Maliheh Amani ◽

Hamid Reza Haghighatkhah ◽

Ehsan Noori ◽

Fahimeh Abdollahimajd

Keyword(s):

Metabolic Syndrome ◽

Subclinical Atherosclerosis ◽

Increased Risk

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Emotional Eating in Adolescence: Effects of Emotion Regulation, Weight Status and Negative Body Image

Nutrients ◽

10.3390/nu13010079 ◽

2020 ◽

Vol 13 (1) ◽

pp. 79

Author(s):

Lenka H. Shriver ◽

Jessica M. Dollar ◽

Susan D. Calkins ◽

Susan P. Keane ◽

Lilly Shanahan ◽

...

Keyword(s):

Body Image ◽

Emotion Regulation ◽

Emotional Regulation ◽

Emotional Eating ◽

Weight Status ◽

Normal Weight ◽

Linear Regression Models ◽

Obesity Risk ◽

Negative Body Image ◽

Increased Risk

Emotional eating is associated with an increased risk of binge eating, eating in the absence of hunger and obesity risk. While previous studies with children and adolescents suggest that emotion regulation may be a key predictor of this dysregulated eating behavior, little is known about what other factors may be influencing the link between emotional regulation and emotional eating in adolescence. This multi-method longitudinal study (n = 138) utilized linear regression models to examine associations between childhood emotion regulation, adolescent weight status and negative body image, and emotional eating at age 17. Emotion regulation predicted adolescent emotional eating and this link was moderated by weight status (β = 1.19, p < 0.01) and negative body image (β = −0.34, p < 0.01). Higher engagement in emotional eating was predicted by lower emotional regulation scores among normal-weight teens (β = −0.46, p < 0.001) but not among overweight/obese teens (β = 0.32, p > 0.10). Higher scores on emotion regulation were significantly associated with lower emotional eating at high (β = −1.59, p < 0.001) and low (β = −1.00, p < 0.01) levels of negative body image. Engagement in emotional eating was predicted by higher negative body image among overweight/obese teens only (β = 0.70, p < 0.001). Our findings show that while better childhood emotion regulation skills are associated with lower emotional eating, weight status and negative body image influence this link and should be considered as important foci in future interventions that aim to reduce emotional eating in adolescence.

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Body mass index and risk of all-cause mortality in normotensive and hypertensive adults: The Rural Chinese Cohort Study

Public Health Nutrition ◽

10.1017/s1368980021001592 ◽

2021 ◽

pp. 1-25

Author(s):

Qionggui Zhou ◽

Xuejiao Liu ◽

Yang Zhao ◽

Pei Qin ◽

Yongcheng Ren ◽

...

Keyword(s):

Cohort Study ◽

Population Based ◽

Normal Weight ◽

Sensitivity Analyses ◽

Hypertension Status ◽

Moderation Effect ◽

Increased Risk ◽

All Cause Mortality ◽

Chinese Cohort ◽

The Impact

Abstract Objective: The impact of baseline hypertension status on the BMI–mortality association is still unclear. We aimed to examine the moderation effect of hypertension on the BMI–mortality association using a rural Chinese cohort. Design: In this cohort study, we investigated the incident of mortality according to different BMI categories by hypertension status. Setting: Longitudinal population-based cohort Participants: 17,262 adults ≥18 years were recruited from July to August of 2013 and July to August of 2014 from a rural area in China. Results: During a median 6-year follow-up, we recorded 1109 deaths (610 with and 499 without hypertension). In adjusted models, as compared with BMI 22-24 kg/m2, with BMI ≤18, 18-20, 20-22, 24-26, 26-28, 28-30 and >30 kg/m2, the HRs (95% CI) for mortality in normotensive participants were 1.92 (1.23-3.00), 1.44 (1.01-2.05), 1.14 (0.82-1.58), 0.96 (0.70-1.31), 0.96 (0.65-1.43), 1.32 (0.81-2.14), and 1.32 (0.74-2.35) respectively, and in hypertensive participants were 1.85 (1.08-3.17), 1.67 (1.17-2.39), 1.29 (0.95-1.75), 1.20 (0.91-1.58), 1.10 (0.83-1.46), 1.10 (0.80-1.52), and 0.61 (0.40-0.94) respectively. The risk of mortality was lower in individuals with hypertension with overweight or obesity versus normal weight, especially in older hypertensives (≥60 years old). Sensitivity analyses gave consistent results for both normotensive and hypertensive participants. Conclusions: Low BMI was significantly associated with increased risk of all-cause mortality regardless of hypertension status in rural Chinese adults, but high BMI decreased the mortality risk among individuals with hypertension, especially in older hypertensives.

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