Diagnostic and prognostic value of adipose tissue content and distribution indicators for normal weight obesity in young women

Abstract

Abstract The rise in global obesity and related health risks has highlighted the importance of precise body composition analysis, especially in individuals who appear healthy according to Body Mass Index (BMI). This study examines the diagnostic and prognostic significance of body composition indicators for assessing cardiometabolic risk in young women with normal weight obesity (NWO). The research included 330 women aged 18–24 years from northwestern Poland with normal BMI (18.5–24.9 kg/m2), using dual-energy X-ray absorptiometry (DXA) for detailed body composition assessment. A key achievement of the study was establishing a new cut-off point for body fat percentage (PBF) at 35.78%, which effectively identified individuals at increased cardiometabolic risk. Results showed that 27.3% of participants were classified as having NWO and exhibited higher insulin levels, increased HOMA-IR scores, and a lipid profile indicative of greater cardiometabolic risk, including elevated total cholesterol, LDL-C, non-HDL-C, and triglycerides, alongside reduced HDL-C levels. The android-to-gynoid (A/G) fat ratio emerged as a significant predictor, correlating positively with insulin resistance and negatively with HDL-C levels. These findings highlight the limitations of BMI and underscore the need for comprehensive body composition analysis. Identifying the NWO phenotype early could prompt preventive lifestyle interventions, even in those with a normal BMI.