Prevalence, incidence, and 6-years stability of metabolically unhealthy normal weights phenotype in u.s. hispanic/latino adults

AIMS: Normal-weight individuals who exhibit cardiometabolic abnormalities similar to those linked to higher body weight (metabolically unhealthy normal-weight, MUNW) are difficult to detect in clinical practice. We examined factors associated with prevalent and 6-years incident MUNW, and the stability of MUNW over this period. METHODS: ; 18-74 years) from the Hispanic Community Health Study/Study of Latinos, free of cardiometabolic disease at baseline. MUNW was defined as normal weight with ≥ 1 cardiometabolic risk factor (CMRF) based on the harmonized metabolic syndrome criteria. Multivariable models evaluated associations with prevalent and 6-years incident MUNW. RESULTS: At baseline, 43.9% had MUNW, which was associated with lower education, unemployment/retirement, and greater waist circumference (WC). At follow-up, 22.9% of initially metabolically healthy normal-weight participants developed MUNW, with age as the main predictor. Baseline MUNW increased the risk of progressing to metabolically unhealthy overweight/obesity (MUO), even after adjustment for baseline BMI and WC (risk ratios 1.85-2.37; p < 0.0001). Those who remained MUNW after 6 years (44.2 %) accumulated more CMRFs (p < 0.05). CONCLUSIONS: MUNW predicts progression to MUO and is associated with worsening cardiometabolic profiles. Screening metabolic health in normal-weight adults may help prevent weight gain and cardiometabolic risk.