Key result
Normal-weight obesity linked to worse cardiometabolic markers, particularly LDL-C, triglycerides, and autonomic indices.
Why the study?
The impact of elevated percentage of body fat on cardiometabolic risk in individuals with normal body mass index remains unclear.
Is normal-weight obesity associated with worse cardiometabolic risk markers and scores compared to normal weight with normal body fat in adults?
Cross-Sectional (n=52)
No
Is normal-weight obesity associated with worse cardiometabolic risk markers and scores compared to normal weight with normal body fat in adults?
Normal-weight obesity is associated with an unfavorable cardiometabolic profile, including worse lipid and autonomic indices, compared to individuals with normal weight and normal body fat.
May warrant closer cardiometabolic monitoring in normal-weight obesity; extends risk stratification but remains hypothesis-generating pending longitudinal trials.
Background: Normal-weight obesity (NWO) is a nutritional status in which individuals have a normal body mass index (BMI) with a high percentage of body fat (%BF). However, the impact of elevated %BF on cardiometabolic risk remains unclear. This study aimed to evaluate whether NWO is associated with worse cardiometabolic risk markers and scores. Methods: We conducted a cross-sectional study using a convenience sample of employees from a public hospital. Participants aged ≥18 years with a BMI between 18.5–24.9 kg/m2 were included in the study. %BF was categorized according to sex and age (InBody720). Normal weight and normal %BF (NWNB) and NWO were defined using cutoff points. Body composition, serum biochemical and inflammatory markers, hemodynamics, and autonomic function were considered cardiometabolic risk markers. The visceral fat area (VFA), atherogenic coefficient (AC), atherogenic index of plasma (AIP), body shape index (ABSI), and Framingham Risk (FR) score were considered cardiometabolic risk scores. Statistical significance was set at p < 0.05. Results: Of the 228 eligible participants, 52 met the inclusion criteria (NWNB, N = 29 and NWO, N = 23). Participants with NWO presented worse values of lipid profiles, anthropometric measurements, hemodynamic parameters, and autonomic function indices. After adjustment for age and sex, NWO remained associated with selected cardiometabolic markers, particularly LDL-c, triglycerides, and autonomic indices, whereas body composition findings should be interpreted as confirmatory of the phenotype. Conclusions: In this cross-sectional secondary analysis, NWO was associated with worse cardiometabolic markers and selected risk scores compared with NWNB. These findings support an unfavorable cardiometabolic profile in individuals with NWO, but do not allow inferences about future cardiometabolic events or causal relationships. Longitudinal studies are needed to clarify its prognostic significance.
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Jesus et al. (2026) conducted a cross-sectional in Normal-weight obesity (n=52). Normal-weight obesity (NWO) vs. Normal weight and normal %BF (NWNB) was evaluated on Cardiometabolic risk markers and scores. Normal-weight obesity was associated with worse cardiometabolic markers, particularly LDL-c, triglycerides, and autonomic indices, compared with normal weight and normal body fat.
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