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A cross-sectional study of the relationship between normal weight obesity and metabolic syndrome in older Korean adults

  • Jeonghyeon Kim1
  • Seamon Kang2
  • Hyunsik Kang1,*,

1College of Sport Science, Sungkyunkwan University, 16419 Suwon, Republic of Korea

2School of Sport Science, Sungkyunkwan University, 16419 Suwon, Republic of Korea

DOI: 10.22514/jomh.2024.053 Vol.20,Issue 4,April 2024 pp.54-63

Submitted: 07 December 2023 Accepted: 05 January 2024

Published: 30 April 2024

*Corresponding Author(s): Hyunsik Kang E-mail:


Body mass index (BMI) has the disadvantage of being unable to differentiate between the distribution and quantity of fat mass and lean mass. Normal weight obesity (NWO) is a distinct phenotype characterized by excessive body fat despite a normal BMI. The purpose of this study was to look at the relationship between NWO and metabolic syndrome in a cross-sectional design of older Korean adults aged ≥65 years. The current study used data from the 2008–2011 Korea National Health and Nutrition Examination Survey (1609 males and 2238 females). NWO was defined as a BMI of 18.5 to 24.9 kg/m2 with a body fat of ≥26.0% in men and body fat of ≥36.0% in women. Metabolic syndrome was defined according to the revised National Cholesterol Education Program definition, with a modified waist circumference threshold of ≥90 cm for men or ≥85 cm for women. People with NWO had an increased risk of metabolic syndrome (odds ratio, OR = 2.357, 95% confidence interval, 95% CI = 1.747–3.179, p < 0.001 in men; OR = 1.885, 95% CI = 1.434–2.399, p < 0.001 in women) compared to people with normal weight non-obesity (OR = 1). However, after controlling the age, education, income, smoking, heavy alcohol consumption, serum vitamin D, physical activity, fat-to-lean mass ratio, and intake of carbohydrates, fats, and proteins, the increased risk of NWO for metabolic syndrome was no longer significant in both genders. The current findings suggest that NWO is significantly and positively related to the risk of metabolic syndrome in older Korean adults.


Normal-weight obesity; Metabolic syndrome; Lifestyle risk factors; Older adults

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Jeonghyeon Kim,Seamon Kang,Hyunsik Kang. A cross-sectional study of the relationship between normal weight obesity and metabolic syndrome in older Korean adults. Journal of Men's Health. 2024. 20(4);54-63.


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