Patterns of Lipid Abnormalities in Obesity: A Comparative Analysis in Normoglycemic and Prediabetic Obese Individuals

<b>Background:</b> Obesity is a growing global health concern, often accompanied by dyslipidemia, contributing to cardiovascular risk. Understanding the patterns of dyslipidemia in different glycemic states is crucial for targeted interventions. This study compares dyslipidemia patterns in normoglycemic and prediabetic obesity to improve clinical management strategies. <b>Methods:</b> The study analyzed the complete lipid profiles of 138 subjects, comparing the medians, prevalence, diagnostic performance, and risk assessment of each lipid parameter across 54 non-obese (NO), 44 normoglycemic obese (NG-OB), and 40 pre-diabetic obese (PreDM-OB) groups. <b>Results:</b> Elevated total cholesterol (TC) and low-density lipoprotein (LDL) were the most prevalent forms of dyslipidemia observed in obesity (45.35% and 43.53%, respectively). Stratification by glycemic status revealed that triglyceride (TG) levels were elevated in both the NG-OB and PreDM-OB groups, with a more marked increase in the latter group (73.07 mg/dL vs. 97.87 mg/dL vs. 121.8 mg/dL, respectively). Elevated LDL showed better diagnostic performance and higher odds ratios (OR) in the NG-OB group (AUC = 0.660, <i>p</i> = 0.006; OR = 2.78, <i>p</i> = 0.022). Conversely, low high-density lipoprotein (HDL) was more common and exhibited significant diagnostic performance, with higher OR values in the PreDM-OB group (AUC = 0.687, <i>p</i> = 0.002; OR = 3.69, <i>p</i> = 0.018). Importantly, all lipid ratios were elevated in obesity, with TC/HDL showing the highest predictive ability for prediabetes (AUC = 0.7491, <i>p</i> < 0.001). <b>Conclusions:</b> These findings revealed unique and common lipid abnormalities in normoglycemic and prediabetic obesity. Future research should explore the effects of targeted lipid management on obesity-associated complications.