The relationship of body fat ratio to anthropometric and metabolic parameters in normal weight and overweight women; the concept of normal weight obesity

ABSTRACT Aim: Although obesity is characterized by an excessive amount of body fat, it is commonly measured using body mass index (BMI). The term of "normal weight obesity (NWO)" was defined as the combination of BMI within the normal range and excess body fat (BF%). There are a lot of study that shows NWO affects biochemical parameters. In this study, we tried to examine the relationship between BF% and anthropometric and metabolic parameters and to revive the term of NWO. And also we aimed to change the polyclinic praxis by not missing out the NWO subjects, arranging treatment of this NWO group and remarking the risks about this situation. Method: In this study, we retrospectively reviewed the archive files of the patients who applied to the Department of Family Medicine at Düzce University between January 2018 and July 2018 and included 200 patients who met our inclusion criteria. Patients were divided into 4 groups according to BMI and BF% status: Normal weight – normal BF% (<%30) group (NWL); normal weight – excess BF% group; overweight – normal BF% group; overweight – excess BF% group. In the study, anthropometric and biochemical parameters were used with bioelectrical impedance analysis (BIA) of the patients. The change of these parameters between the groups and the correlation between each other were examined. SPSS package program was used for statistical evaluations and p <0.05 was considered statistically significant. Results: Serum levels of important biochemical parameters like fasting plasma glucose, insulin, HOMA-IR, total cholesterol (TC), LDL, triglyceride (TG) and TSH were higher in NWO subjects than NWL subjects. But these wasn't statically significant probably due to the small number of patients. The mean LDL levels was found to be higher in the NWO group compared to the other groups and it was found to be statistically significant. BF% was positively correlated to insulin, HOMA-IR, visceral fat rating, waist - hip circumferences, waist to height - hip to height ratios but there wasnt significant association between BF% and TC, TG, LDL, HDL levels. Conclusion: BF% detection has an important place in the fight against obesity. A practical method, BIA, stands out and is recommended. Considering the results obtained in the study, evaluation of patients in terms of obesity in primary care, community screening and polyclinics should be done not only by weight-height measurement but by detailed body composition determination. Keywords: Normal weight obesity, body fat ratio, bioelectric impedance analysis, insülin resistance, anthropometric measurement