{
  "abstract": "Objective To investigate associations between body composition indices and metabolic status among normal-weight adults.Design Cross-sectional study using data from the Tehran Lipid and Glucose Study (phase VII: 2019–2021).Setting Primary care and community health services in an urban Tehran population.Participants 1298 adults (40.5% men, 59.5% women), aged 18–80 years, body mass index (BMI) 18.5–24.9 kg/m². Exclusions: known diabetes, cardiovascular disease, kidney failure, malignancy, pregnancy or lactation, diuretic or glucocorticoid use. Participants were classified as metabolically healthy normal weight (MHNW) or unhealthy (MUHNW).Primary and secondary outcome measures The primary outcome was the association between body composition and anthropometric indices with metabolic status. The secondary outcome was identification of the strongest predictors of MUHNW. Body composition was assessed by bioelectrical impedance analysis to obtain fat mass (FM), body fat percentage (BFP), skeletal muscle mass percentage (SMM%), fat mass index (FMI), fat-free mass index, skeletal muscle indices and the fat-to-muscle mass ratio (FMR). Anthropometric measures included waist circumference (WC) and waist-to-hip ratio (WHR). Associations were examined using logistic regression adjusted for age, smoking and physical activity.Results Mean age: 37.5 ± 12.8 y; MUHNW participants were older than MHNW (44.5 ± 13.2 vs 35.8 ± 12.1 years, p<0.001). MUHNW prevalence was 19.4% (higher in men, p<0.001). Adjusted mean BMI, WC, WHR, FM, BFP, FMR and FMI were higher in MUHNW in both sexes. SMM% was protective in men (OR  0.90, 95% CI 0.84 to 0.96). WHR was the strongest predictor of MUHNW (OR  1.52, 95% CI 1.20 to 1.93 men; OR  1.31, 95% CI 1.07 to 1.61 women).Conclusions BMI, WC, WHR and body fat indices were positively associated with metabolically unhealthy status among normal-weight adults of both sexes. WHR was the strongest predictor, highlighting its value for identifying at-risk individuals where advanced body composition tools are unavailable.",
  "authors": [
    {
      "affiliations": [
        "Shahid Beheshti University of Medical Sciences Research Institute for Endocrine Sciences, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Suzan Maleki"
    },
    {
      "affiliations": [
        "Shahid Beheshti University of Medical Sciences Research Institute for Endocrine Sciences, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Farhad Hosseinpanah"
    },
    {
      "affiliations": [
        "Shahid Beheshti University of Medical Sciences Research Institute for Endocrine Sciences, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Maryam Mahdavi"
    },
    {
      "affiliations": [
        "Shahid Beheshti University of Medical Sciences Research Institute for Endocrine Sciences, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Amir Abbas Momenan"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Seyyed Alireza Ebadi"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Fatemeh Rahmani"
    },
    {
      "affiliations": [
        "Shahid Beheshti University of Medical Sciences Research Institute for Endocrine Sciences, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Fereidoun Azizi"
    },
    {
      "affiliations": [
        "Shahid Beheshti University of Medical Sciences Research Institute for Endocrine Sciences, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Majid Valizadeh"
    }
  ],
  "title": "Associations between indices of body composition and metabolic status in normal-weight adults: a cross-sectional study of the Tehran Lipid and Glucose Study",
  "uid": "1053405f-0e8f-5d88-99a5-e98ba085aa63"
}