Normal-Weight Obesity and an Unfavorable Cardiometabolic Profile: Results from the Study of Workers’ Health (ESAT)

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: < 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.