Abstract Background Normal weight obesity (NWO) has been linked to metabolic syndrome (MetS), cardiovascular disease (CVD) and mortality, but has not been comprehensively studied in the Hispanic population. Purpose Our study aims to examine the CVD risk factors associated with NWO and to compare the development of CVD risk factors between NWO and normal weight non-obese (NWNO) Hispanic adults over 6 years. Methods This is a prospective study using data from the Hispanic Community Health Study (HCHS). Interviews and clinical assessments were collected from 2008–2011 (visit 1) to 2014–2017 (visit 2). NWO was defined as a body mass index (BMI) between 18.5–24.9 kg/m2 and a body fat percentage of ≥25 % in men and ≥35% in women, estimated using the Tanita scale. We identified 1,000 HCHS participants as having a normal weight at visit 1 and not missing data on covariates of interest including hypertension (HTN), hyperlipidemia (HLD), MetS, and insulin resistance (Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) ≥2.5). Participants were categorized into NWO (n=104) or NWNO (n=896) groups. Univariate logistic regression models were used to estimate the odds ratio (OR) and 95% confidence intervals (CI) of the association between health risk factors and NWO. Multivariate logistic regression models were used to estimate the odds of developing CVD risk factors over 6 years, using propensity score matching. Results The prevalence of NWO among our sample of Hispanic adults was 10.4% and the 6-year incidence of NWO at visit 2 was 3.5% (n=31) from NWNO participants at visit 1. Higher BMI (OR=5.19; 95% CI=3.15–9.27, p0.001) and a higher mean overnight heart rate (OR=1.34; 95% CI=1.01–1.79, p=0.043) were statistically significantly associated with NWO at visit 1. Furthermore, HTN (OR=2.88; 95% CI=1.31–6.71, p=0.011), HLD (OR=2.12; 95% CI=1.21–3.77, p=0.009), and MetS (OR=3.48; 95% CI=1.62–8.09, p=0.002) were statistically significantly associated with NWO at visit 1. Participants with NWO at visit 1 had higher odds of developing insulin resistance (OR=1.79; 95% CI=1.07–3.04, p=0.029) and MetS (OR=2.03; 95% CI=1.15–3.66, p=0.016) at visit 2 compared to NWNO participants at visit 1, after age and sex matching. Conclusion Among Hispanic adults, the prevalence of NWO was associated with a higher BMI, higher mean overnight heart rate, treated HTN, HLD, and MetS. Hispanic adults with NWO were more likely to develop insulin resistance and MetS over 6 years compared to NWNO Hispanic adults. Overall, NWO among Hispanic adults was associated with CVD risk factors which places this population at a higher risk for CVD morbidity and mortality.
Rizzo et al. (Sat,) studied this question.