Body fat percentage is associated with cardiometabolic dysregulation in BMI-defined normal weight subjects

Nutr Metab Cardiovasc Dis. 2012 Sep;22(9):741-7. doi: 10.1016/j.numecd.2010.11.009. Epub 2011 Jan 7.


Background and aims: 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.

Methods and 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.

Conclusion: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Adiposity*
  • Adult
  • Aged
  • Body Mass Index*
  • Body Weight*
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Cholesterol, HDL
  • Female
  • Humans
  • Hypertension / epidemiology
  • Hypertension / etiology
  • Hypertriglyceridemia / epidemiology
  • Hypertriglyceridemia / etiology
  • Insulin Resistance
  • Logistic Models
  • Male
  • Middle Aged
  • Newfoundland and Labrador / epidemiology
  • Obesity / complications
  • Obesity / physiopathology
  • Prevalence
  • Risk Factors
  • Waist Circumference
  • Young Adult


  • Cholesterol, HDL