Assessment of Cardiometabolic Risk According to Body Fat Distribution in Adults With Normal Body Weight

Abstract

Body mass index may not adequately reflect cardiometabolic risk among adults with normal body weight because it does not account for differences in body fat distribution. This study assessed cardiometabolic risk according to adiposity distribution in adults with normal BMI. A cross-sectional observational study included 160 adults aged 30–65 years with BMI between 18.5 and 24.9 kg/m². Waist circumference, waist-to-height ratio, fasting glucose, insulin, lipid profile, blood pressure, and inflammatory markers were assessed. Participants with greater central adiposity had higher fasting insulin, HOMA-IR, triglycerides, and blood pressure and lower HDL cholesterol despite having similar BMI values. Waist-to-height ratio was positively associated with cardiometabolic risk markers after adjustment for age and sex. These findings suggest that normal BMI does not necessarily indicate a favorable metabolic profile and that assessment of body fat distribution may provide additional information regarding cardiometabolic risk.