title: Body fat percentage is associated with cardiometabolic dysregulation in BMI-defined normal weight subjects.
abstract: OBJECTIVE
  Nearly 25% of normal weight individuals display abnormal metabolic profiles associated with obesity. As a wide range in body fat percentage (%BF) exists for BMI-defined normal weight individuals, we investigated whether elevated %BF (determined using DXA) was associated with cardiometabolic dysregulation among 977 normal weight subjects (192 men, 785 women) from the Canadian province of Newfoundland and Labrador.
  
  
  RESULTS
  BMI and %BF were measured after a 12-h fasting period. Cardiometabolic abnormalities considered included elevated triglyceride, glucose and hsCRP levels, decreased HDL cholesterol, insulin resistance, and hypertension. Subjects were classified as metabolically healthy (0 or 1 cardiometabolic abnormality) or abnormal (≥2 cardiometabolic abnormalities) and divided into sex-specific %BF tertiles as follows: low (≤15.2% men, ≤29.7% women), medium (15.3-20.7%% men, 29.8-34.9%% women) and high (≥20.8% men, ≥35.0% women). The prevalence of the metabolically abnormal phenotype was higher among medium and high %BF subjects (12.0% and 19.5%, respectively) compared to the low group (7.4%; p < 0.05). Furthermore, the odds of being metabolically abnormal were 1.61 (95% CI 0.94-2.77) for medium %BF subjects compared to the low group and nearly tripled for high %BF subjects (OR 2.73, 95% CI 1.63-4.86). ORs remained significant after further adjustment for waist circumference.
  
  
  CONCLUSIONS
  Our findings indicate that those with elevated %BF are at increased risk of developing cardiometabolic disease despite having a normal BMI. Future development of adequate screening tools to identify these individuals is crucial to the prevention of obesity-associated disease.
authors.affiliation: Department of Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.
authors.forename: J L
authors.initials: JL
authors.lastname: Shea
authors.forename: M T C
authors.initials: MT
authors.lastname: King
authors.forename: Y
authors.initials: Y
authors.lastname: Yi
authors.forename: W
authors.initials: W
authors.lastname: Gulliver
authors.forename: G
authors.initials: G
authors.lastname: Sun
mesh_terms: D015502:Absorptiometry, Photon; D050154:Adiposity; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D008076:Cholesterol, HDL; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D015228:Hypertriglyceridemia / Q000453:epidemiology / Q000209:etiology; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009523:Newfoundland and Labrador / Q000453:epidemiology; D009765:Obesity / Q000150:complications / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL