Cardiometabolic risk in adolescents with normal weight obesity

Background Normal weight obesity (NWO), which is defined by the excess of body fat in normal weight individuals, has been neglected among adolescents, due to their normal weight and young age. Few studies were carried out on the topic with adolescents. Objective To analyze whether the NWO is associated with cardiometabolic risk factors in adolescents. Subjects/Methods Cross-sectional study, with 506 normal weight adolescents aged 10–19 years, selected in schools in Brazil. Weight, height, waist circumference (WC) and neck circumference were obtained and the body mass index (BMI) and waist/height ratio (WHR) were calculated. Body composition analysis was performed using dual-energy X-ray absorptiometry. The clinical evaluation included lipid and glycid profile, platelets, leukocytes, lymphocytes, monocytes, uric acid and blood pressure, as well as the presence of metabolic syndrome (MS) and its components. NWO was defined by the presence of normal weight, according to BMI for age, and excess body fat (≥25% and ≥30% in males and females, respectively). Logistic regression models were used to analyze associations between normal weight adolescents with and without the NWO phenotype. Results NWO associated positively with abdominal obesity, analyzed through WC (OR = 1.36;95%CI = 1.27–1.47), WHR (OR = 25.89;95%CI = 10.43–64.26) and android fat (OR = 1.49;95%CI = 1.36–1.63); insulin resistance (OR = 4.09;95%CI = 1.72–9.70), hyperinsulinemia (OR = 3.83;95%CI = 1.50–9.76) and the highest values of the triglycerides-glycemia index (OR = 4.28;95%CI = 1.21–15.08); uric acid (OR = 1.81;95%CI = 1.29–2.55), as well as the changes in LDL (OR = 3.39;95%CI = 1.47–7.81), total cholesterol (OR = 2.77;95%CI = 1.22–6.29), and in at least one (OR = 1.87;95%CI = 1.04–3.37) or two (OR = 6.61;95%CI = 1.45–30.19) components of MS. Conclusion NWO is associated with the presence of cardiometabolic risk factors in adolescents.