Metabolic disturbances in normal-weight obesity: a cross-sectional study of Iranian employees

Purpose Normal-weight obesity (NWO), characterized by normal body mass index (BMI) but excess body fat, is a potential contributor to chronic diseases. This study aims to assess the relationship between this phenomenon and some metabolic factors in a population of Iranian employees. Design/methodology/approach This cross-sectional study was conducted on Iranian employees from the baseline data of Employees Health Cohort Study, Shiraz, Iran. Anthropometric measures, including weight, height, waist circumference and percentage of body fat, were obtained from the cohort database. The participants were divided into three groups: healthy, normal-weight obese and overweight/obese. Metabolic variables including blood pressure, fasting blood sugar, lipid profile, liver function enzymes and metabolic syndrome were assessed in relation to the study groups. Findings A total of 985 participants aged 25–64 years were included. Males with NWO had significantly higher alanine aminotransferase (ALT) levels compared to the healthy group in the fully adjusted model. Also, high-density lipoprotein (HDL) was significantly lower among females with overweight/obesity than healthy group when adjusted for age and energy intake. Furthermore, after adjusting for age and energy intake, both genders in the overweight/obese group showed significantly elevated systolic and diastolic blood pressure, while this was not observed for the NWO group. Lastly, metabolic syndrome was more prevalent in NWO as well as overweight/obesity. Originality/value These findings further encourage identification of excess body fat, even in normal-weight individuals, to prevent chronic metabolic diseases. Special attention should be paid to subgroups with sedentary occupations, as they may be at increased risk for NWO-related health issues.