title: Normal weight obesity is associated with metabolic syndrome and insulin resistance in young adults from a middle-income country.
abstract: OBJECTIVE
  This population-based birth cohort study examined whether normal weight obesity is associated with metabolic disorders in young adults in a middle-income country undergoing rapid nutrition transition.
  
  
  METHODS
  The sample involved 1,222 males and females from the 1978/79 Ribeirão Preto birth cohort, Brazil, aged 23-25 years. NWO was defined as body mass index (BMI) within the normal range (18.5-24.9 kg/m(2)) and the sum of subscapular and triceps skinfolds above the sex-specific 90th percentiles of the study sample. It was also defined as normal BMI and % BF (body fat) >23% in men and >30% in women. Insulin resistance (IR), insulin sensitivity and secretion were based on the Homeostasis Model Assessment (HOMA) model.
  
  
  RESULTS
  In logistic models, after adjusting for age, sex and skin colour, NWO was significantly associated with Metabolic Syndrome (MS) according to the Joint Interim Statement (JIS) definition (Odds Ratio OR = 6.83; 95% Confidence Interval CI 2.84-16.47). NWO was also associated with HOMA2-IR (OR = 3.81; 95%CI 1.57-9.28), low insulin sensitivity (OR = 3.89; 95%CI 2.39-6.33), and high insulin secretion (OR = 2.17; 95%CI 1.24-3.80). Significant associations between NWO and some components of the MS were also detected: high waist circumference (OR = 8.46; 95%CI 5.09-14.04), low High Density Lipoprotein cholesterol (OR = 1.65; 95%CI 1.11-2.47) and high triglyceride levels (OR = 1.93; 95%CI 1.02-3.64). Most estimates changed little after further adjustment for early and adult life variables.
  
  
  CONCLUSIONS
  NWO was associated with MS and IR, suggesting that clinical assessment of excess body fat in normal-BMI individuals should begin early in life even in middle-income countries.
authors.affiliation: Physical Education Undergraduate Course, State University of Piauí, Teresina, Brazil.
authors.forename: Francilene B
authors.initials: FB
authors.lastname: Madeira
authors.forename: Antônio A
authors.initials: AA
authors.lastname: Silva
authors.forename: Helma F
authors.initials: HF
authors.lastname: Veloso
authors.forename: Marcelo Z
authors.initials: MZ
authors.lastname: Goldani
authors.forename: Gilberto
authors.initials: G
authors.lastname: Kac
authors.forename: Viviane C
authors.initials: VC
authors.lastname: Cardoso
authors.forename: Heloisa
authors.initials: H
authors.lastname: Bettiol
authors.forename: Marco A
authors.initials: MA
authors.lastname: Barbieri
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism / Q000473:pathology; D000328:Adult; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D055815:Young Adult
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