Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality

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...

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Published in:	European heart journal Vol. 31; no. 6; p. 737
Main Authors:	Romero-Corral, Abel, Somers, Virend K, Sierra-Johnson, Justo, Korenfeld, Yoel, Boarin, Simona, Korinek, Josef, Jensen, Michael D, Parati, Gianfranco, Lopez-Jimenez, Francisco
Format:	Journal Article
Language:	English
Published:	England 01.03.2010
Subjects:	Adipose Tissue - metabolism Adult Aged Body Composition - physiology Body Mass Index Cardiovascular Diseases - metabolism Cardiovascular Diseases - mortality Female Humans Male Metabolic Syndrome - mortality Middle Aged Obesity - metabolism Obesity - mortality Risk Factors United States - epidemiology Young Adult
ISSN:	1522-9645, 1522-9645
Online Access:	Get more information
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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.
AbstractList	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.AIMSWe 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.METHODS AND RESULTSWe 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.CONCLUSIONNormal 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. 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.
Author	Korinek, Josef Romero-Corral, Abel Somers, Virend K Sierra-Johnson, Justo Parati, Gianfranco Lopez-Jimenez, Francisco Jensen, Michael D Korenfeld, Yoel Boarin, Simona
Author_xml	– sequence: 1 givenname: Abel surname: Romero-Corral fullname: Romero-Corral, Abel organization: Mayo Clinic College of Medicine, Rochester, MN, USA – sequence: 2 givenname: Virend K surname: Somers fullname: Somers, Virend K – sequence: 3 givenname: Justo surname: Sierra-Johnson fullname: Sierra-Johnson, Justo – sequence: 4 givenname: Yoel surname: Korenfeld fullname: Korenfeld, Yoel – sequence: 5 givenname: Simona surname: Boarin fullname: Boarin, Simona – sequence: 6 givenname: Josef surname: Korinek fullname: Korinek, Josef – sequence: 7 givenname: Michael D surname: Jensen fullname: Jensen, Michael D – sequence: 8 givenname: Gianfranco surname: Parati fullname: Parati, Gianfranco – sequence: 9 givenname: Francisco surname: Lopez-Jimenez fullname: Lopez-Jimenez, Francisco
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/19933515$$D View this record in MEDLINE/PubMed
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Snippet	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...
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SubjectTerms	Adipose Tissue - metabolism Adult Aged Body Composition - physiology Body Mass Index Cardiovascular Diseases - metabolism Cardiovascular Diseases - mortality Female Humans Male Metabolic Syndrome - mortality Middle Aged Obesity - metabolism Obesity - mortality Risk Factors United States - epidemiology Young Adult
Title	Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality
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