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Original Research

Open Access

A cross-sectional study of the relationship between normal weight obesity and metabolic syndrome in older Korean adults

  • Jeonghyeon Kim1
  • Seamon Kang2
  • Hyunsik Kang1,*,

1College of Sport Science, Sungkyunkwan University, 16419 Suwon, Republic of Korea

2School of Sport Science, Sungkyunkwan University, 16419 Suwon, Republic of Korea

DOI: 10.22514/jomh.2024.053 Vol.20,Issue 4,April 2024 pp.54-63

Submitted: 07 December 2023 Accepted: 05 January 2024

Published: 30 April 2024

*Corresponding Author(s): Hyunsik Kang E-mail: hkang@skku.edu

Abstract

Body mass index (BMI) has the disadvantage of being unable to differentiate between the distribution and quantity of fat mass and lean mass. Normal weight obesity (NWO) is a distinct phenotype characterized by excessive body fat despite a normal BMI. The purpose of this study was to look at the relationship between NWO and metabolic syndrome in a cross-sectional design of older Korean adults aged ≥65 years. The current study used data from the 2008–2011 Korea National Health and Nutrition Examination Survey (1609 males and 2238 females). NWO was defined as a BMI of 18.5 to 24.9 kg/m2 with a body fat of ≥26.0% in men and body fat of ≥36.0% in women. Metabolic syndrome was defined according to the revised National Cholesterol Education Program definition, with a modified waist circumference threshold of ≥90 cm for men or ≥85 cm for women. People with NWO had an increased risk of metabolic syndrome (odds ratio, OR = 2.357, 95% confidence interval, 95% CI = 1.747–3.179, p < 0.001 in men; OR = 1.885, 95% CI = 1.434–2.399, p < 0.001 in women) compared to people with normal weight non-obesity (OR = 1). However, after controlling the age, education, income, smoking, heavy alcohol consumption, serum vitamin D, physical activity, fat-to-lean mass ratio, and intake of carbohydrates, fats, and proteins, the increased risk of NWO for metabolic syndrome was no longer significant in both genders. The current findings suggest that NWO is significantly and positively related to the risk of metabolic syndrome in older Korean adults.


Keywords

Normal-weight obesity; Metabolic syndrome; Lifestyle risk factors; Older adults


Cite and Share

Jeonghyeon Kim,Seamon Kang,Hyunsik Kang. A cross-sectional study of the relationship between normal weight obesity and metabolic syndrome in older Korean adults. Journal of Men's Health. 2024. 20(4);54-63.

References

[1] Lin X, Li H. Obesity: epidemiology, pathophysiology, and therapeutics. Frontiers in Endocrinology. 2021; 12: 706978.

[2] Caleyachetty R, Barber TM, Mohammed NI, Cappuccio FP, Hardy R, Mathur R, et al. Ethnicity-specific BMI cutoffs for obesity based on type 2 diabetes risk in England: a population-based cohort study. The Lancet Diabetes & Endocrinology. 2021; 9: 419–426.

[3] Bawadi H, Hassan S, Shanbeh Zadeh A, Sarv H, Kerkadi A, Tur JA, et al. Age and gender specific cut-off points for body fat parameters among adults in Qatar. Nutrition Journal. 2020; 19: 75.

[4] Sergi TE, Bode KB, Hildebrand DA, Dawes JJ, Joyce JM. Relationship between body mass index and health and occupational performance among law enforcement officers, firefighters, and military personnel: a systematic review. Current Developments in Nutrition. 2023; 7: 100020.

[5] Wong JC, O’Neill S, Beck BR, Forwood MR, Khoo SK. Comparison of obesity and metabolic syndrome prevalence using fat mass index, body mass index and percentage body fat. PLOS ONE. 2021; 16: e02454.

[6] Blüher M. Metabolically healthy obesity. Endocrine Reviews. 2020; 41: bnaa004.

[7] Mohammadian Khonsari N, Khashayar P, Shahrestanaki E, Kelishadi R, Mohammadpoor Nami S, Heidari-Beni M, et al. Normal weight obesity and cardiometabolic risk factors: a systematic review and meta-analysis. Frontiers in Endocrinology. 2022; 13: 857930.

[8] Kim MK, Han K, Kwon HS, Song KH, Yim HW, Lee WC, et al. Normal weight obesity in Korean adults. Clinical Endocrinology. 2014; 80: 214–220.

[9] Ji T, Zhang L, Tang Z, Sun F, Li Y, Ma L. Prevalence of normal-weight obesity in community-dwelling Chinese older adults: results from the Beijing Longitudinal Study of Aging. Diabetes, Metabolic Syndrome and Obesity. 2020; 13: 1611–1617.

[10] Batsis JA, Sahakyan KR, Rodriguez-Escudero JP, Bartels SJ, Lopez-Jimenez F. Normal weight obesity and functional outcomes in older adults. European Journal of Internal Medicine. 2014; 25: 517–522.

[11] Martinez KE, Tucker LA, Bailey BW, LeCheminant JD. Expanded normal weight obesity and insulin resistance in us adults of the national health and nutrition examination survey. Journal of Diabetes Research. 2017; 2017: 9502643.

[12] Di Renzo L, Galvano F, Orlandi C, Bianchi A, Di Giacomo C, La Fauci L, et al. Oxidative stress in normal-weight obese syndrome. Obesity. 2010; 18: 2125–2130.

[13] Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C; American Heart Association; National Heart, Lung, and Blood Institute. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004; 109: 433–438.

[14] Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ, et al. Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Research and Clinical Practice. 2007; 75: 72–80.

[15] Oh K, Kim Y, Kweon S, Kim S, Yun S, Park S, et al. Korea national health and nutrition examination survey, 20th anniversary: accomplishments and future directions. Epidemiology and Health. 2021; 43: e2021025.

[16] Romero-Corral A, Somers VK, Sierra-Johnson J, Korenfeld Y, Boarin S, Korinek J, et al. Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality. European Heart Journal. 2010; 31: 737–746.

[17] Ashtary-Larky D, Niknam S, Alipour M, Bagheri R, Asbaghi O, Mohammadian M, et al. Are women with normal-weight obesity at higher risk for cardiometabolic disorders? Biomedicines. 2023; 11: 341.

[18] Shirasawa T, Ochiai H, Yoshimoto T, Nagahama S, Kobayashi M, Ohtsu I, et al. Associations between normal weight central obesity and cardiovascular disease risk factors in Japanese middle-aged adults: a cross-sectional study. Journal of Health, Population and Nutrition. 2019; 38: 46.

[19] Coelho CCNDS, Bragança MLBM, de Oliveira BR, Bettiol H, Barbieri MA, Cardoso VC, et al. Incidence of metabolic syndrome in adults with healthy weight, normal weight obesity, and overweight/obesity. Nutrition. 2021; 85: 111134.

[20] Lin T, Lim P, Hung S. Normal-weight obesity and clinical outcomes in nondiabetic chronic kidney disease patients: a cohort study. The American Journal of Clinical Nutrition. 2018; 107: 664–672.

[21] Beijers RJHCG, van de Bool C, van den Borst B, Franssen FME, Wouters EFM, Schols AMWJ. Normal weight but low muscle mass and abdominally obese: implications for the cardiometabolic risk profile in chronic obstructive pulmonary disease. Journal of the American Medical Directors Association. 2017; 18: 533–538.

[22] Liu B, Giffney HE, Arthur RS, Rohan TE, Dannenberg AJ. Cancer risk in normal weight individuals with metabolic obesity: a narrative review. Cancer Prevention Research. 2021; 14: 509–520.

[23] Sharma S, Batsis JA, Coutinho T, Somers VK, Hodge DO, Carter RE, et al. Normal-weight central obesity and mortality risk in older adults with coronary artery disease. Mayo Clinic Proceedings. 2016; 91: 343–351.

[24] Kim J, Lee Y, Kye S, Chung Y, Lee O. Association of serum vitamin D with osteosarcopenic obesity: Korea National Health and Nutrition Examination Survey 2008–2010. Journal of Cachexia, Sarcopenia and Muscle. 2017; 8: 259–266.

[25] Oliveros E, Somers VK, Sochor O, Goel K, Lopez-Jimenez F. The concept of normal weight obesity. Progress in Cardiovascular Diseases. 2014; 56: 426–433.

[26] García-Hermoso A, Agostinis-Sobrinho C, Camargo-Villalba GE, González-Jiménez NM, Izquierdo M, Correa-Bautista JE, et al. Normal-weight obesity is associated with poorer cardiometabolic profile and lower physical fitness levels in children and adolescents. Nutrients. 2020; 12: 1171.

[27] Kobayashi M, Pattarathitwat P, Pongprajakand A, Kongkaew S. Association of normal weight obesity with lifestyle and dietary habits in young Thai women: a cross-sectional study. Obesity Pillars. 2023; 5: 100055.

[28] Stefan N. Metabolically healthy and unhealthy normal weight and obesity. Endocrinology and Metabolism. 2020; 35: 487–493.

[29] Huang WY, Chang CC, Chen DR, Kor CT, Chen TY, Wu HM. Circulating leptin and adiponectin are associated with insulin resistance in healthy postmenopausal women with hot flashes. PLOS ONE. 2017; 12: e0176430.

[30] Mazur-Bialy AI. Asprosin-a fasting-induced, glucogenic, and orexigenic adipokine as a new promising player. Will it be a new factor in the treatment of obesity, diabetes, or infertility? A review of the literature. Nutrients. 2021; 13: 620.

[31] Mehrabian S, Taheri E, Karkhaneh M, Qorbani M, Hosseini S. Association of circulating irisin levels with normal weight obesity, glycemic and lipid profile. Journal of Diabetes & Metabolic Disorders. 2015; 15: 17.

[32] You T, Wang X, Murphy KM, Lyles MF, Demons JL, Yang R, et al. Regional adipose tissue hormone/cytokine production before and after weight loss in abdominally obese women. Obesity. 2014; 22: 1679–1684.

[33] DiStefano JK, Gerhard GS. NAFLD in normal weight individuals. Diabetology & Metabolic Syndrome. 2022; 14: 45.

[34] Stefan N, Schick F, Birkenfeld AL, Häring H, White MF. The role of hepatokines in NAFLD. Cell Metabolism. 2023; 35: 236–252.


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