ArticleInternational journal of obesity (2005)2026
Cardiovascular disease and metabolic dysfunction-associated steatotic liver disease incidence in metabolically healthy and unhealthy normal weight obesity.
Article in International journal of obesity (2005), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Lifestyle mediates the association between normal-weight visceral obesity and MASLD in older adults with hypertension and diabetes.Frontiers in nutrition · 2026Article
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10 authors.
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Abstract
backgroundNormal weight obesity (NWO) is characterized by a normal body mass index (BMI) and elevated body fat. Heterogeneous risk has been observed in people with obesity (BMI > 30) when considering metabolic risk factors (MRFs) such as high C-reactive protein, low-density lipoprotein, blood pressure, hemoglobin A1C, triglycerides, and low high-density lipoprotein.
objectivesWe assessed heterogeneity between metabolically healthy (MH) and metabolically unhealthy (MU) subjects with NWO in relation to (1) incident cardiovascular disease (CVD) and metabolic dysfunction-associated steatotic liver disease (MASLD) along with (2) changes in heart physiology, liver function (assessed with imaging), and cardiometabolic/liver serum biomarkers.
methodsIn total, 121,586 subjects were classified into the following experimental groups: a healthy normal weight lean reference group ( ≤ 2 MRFs), MH-NWO ( ≤ 2 MRFs), MU-NWO ( > 2 MRFs), and people with overweight/obesity (OW/O) were classified as MH-OW/O ( ≤ 2 MRFs) or MU-OW/O ( > 2 MRFs). Primary outcomes were incident CVD and MASLD analyzed using Firth logistic regression and displayed via odds ratios (OR) and 95%-confidence intervals (95%-CI). Secondary outcomes were cross-sectional cardiac/liver imaging, serum liver enzyme, and lipid biomarkers analyzed using quantile regression. Results were deemed significant at false discovery rate (FDR) < 0.05.
resultsMU-NWO had higher odds of ischemic heart disease (OR 1.68, 95%-CI 1.36-2.05, FDR = 0.000007), myocardial infarction (OR 1.72, 95%-CI 1.38-2.11, FDR = 0.000007), all-cause mortality (OR 1.29, 95%-CI 1.05-1.56, FDR = 0.02), and CVD death (I0-I99); (OR 1.86, 95%-CI 1.27-2.64, FDR = 0.0036) while MH-NWO saw no significant differences. Among female subjects, both MH-NWO (OR 1.37, 95%-CI 1.04-1.78, FDR = 0.03) and MU-NWO (OR 1.78, 95%-CI 1.05-2.83, FDR = 0.03) had increased odds of MASLD. Biochemical and imaging data were consistent with enhanced CVD and MASLD risk.
conclusionMRFs may modulate CVD and MASLD risk in NWO.
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