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
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Summary: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.
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ISSN:1522-9645
1522-9645
DOI:10.1093/eurheartj/ehp487