Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access
Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc
Journal website https://www.jofem.org

Original Article

Volume 13, Number 3, August 2023, pages 104-113

Prevalence of Metabolically-Obese Normal-Weight Worldwide: Systematic Review and Meta-Analysis

Figures

Figure 1.
Figure 1. Flow chart.
Figure 2.
Figure 2. Regional prevalence of the studies selected for the review.
Figure 3.
Figure 3. Forest plot of the prevalence of studies with truly representative samples.
Figure 4.
Figure 4. Forest plot of the studies that consider the AHA/NHLBI criteria for the diagnosis of metabolic disorder.
Figure 5.
Figure 5. Forest plot of the studies that consider ATP III criteria for the diagnosis of metabolic disorder.
Figure 6.
Figure 6. Forest plot of the studies that consider IDF criteria for the diagnosis of metabolic disorder.
Figure 7.
Figure 7. Forest plot of the studies that consider JIS criteria for the diagnosis of metabolic disorder.

Tables

Table 1. Criteria Used to Define Metabolic Disorders
 
ATP IIIIDFAHA/NHLBIJIS
HDL: high-density lipoprotein.
Absolutely requiredNoneIncreased waist circumferenceNoneNone
CriterionAt least three criteriaAt least two criteria in addition to waist circumferenceAt least three criteriaAt least three criteria
Waist circumference> 102 cm (men); > 89 cm (women)≥ 94 cm (men); ≥ 80 cm (women)>102 cm (men); > 89 cm (women)> 85 cm (men); > 80 cm (women)
Blood pressure≥ 130/85 mm Hg≥ 130/85 mm Hg≥ 130/85 mm Hg≥ 130/85 mm Hg
Fasting triglycerides≥ 150 mg/dL≥ 150 mg/dL≥ 150 mg/dL≥ 150 mg/dL
HDL cholesterol< 40 mg/dL (men); < 50 mg/dL (women)< 40 mg/dL (men); < 50 mg/dL (women)< 40 mg/dL (men); < 50 mg/dL (women)< 40 mg/dL (men); < 50 mg/dL (women)
Higher fasting blood sugar≥ 100 mg/dL≥ 100 mg/dL≥ 100 mg/dL≥ 100 mg/dL

 

Table 2. Characteristics of the Studies Included in the Review
 
Authors (yeara)CountryMetabolic disorder criteriaSample with normal BMIMONWMONW prevalenceAge range
aThe year in which the population was studied. MONW: metabolically-obese normal-weight; BMI: body mass index.
Bradshaw et al (1987) [12]United StatesATP III4,8234439.18%45 - 64
Amouzegar et al (1996) [8]IranJIS66610716.06%≥ 20
Lee et al (2003) [13]South KoreaAHA/NHLBI75321628.68%≥ 40
Goday et al (2004) [14]SpainATP III202,2654,4192.18%34 - 55
Hadaegh et al (2006) [15]IranATP III3,44436110.48%≥ 20
Lee et al (2007) [16]South KoreaPresence of diabetes mellitus, hypertension or dyslipidemia18,5248,71127.9%40 - 69
Jia et al (2007) [17]ChinaJIS9,9882,87728.80%≥ 20
Gomez-Huelgas et al (2007) [18]SpainIDF84117921.28%18 - 80
Moazzami et al (2009) [19]United StatesAHA/NHLBI11,6802,29419.64%≥ 18
Wang et al (2009) [9]ChinaATP III6,9732,09930.1%≥ 18
Tian et al (2009) [20]ChinaATP III5,4531,67830.77%18 - 85
Zheng et al (2010) [21]ChinaWGOC17,8766,09734.1%≥ 20
Suliga et al (2010) [22]PolandIDF13,1726,21747.2%37 - 66
Zhang (2010) [23]ChinaIDF11,8849688.14%≥ 39
Benziger et al (2010) [24]PeruIDF89038343.03%≥ 35
Kim et al (2011) [25]South KoreaAt least one of six metabolic disorders79,01236,17845.78%≥ 35
Buscemi et al (2011) [26]ItalyAt least two of four metabolic disorders2849734.15%18 - 90
Perini et al (2011) [27]The NetherlandsATP III6,9101,06015.34%18 - 70
Li et al (2011) [28]ChinaATP III2,9111,01834.97%≥ 40
Hajian-Tilaki, Heidari (2012) [29]IranATP III32417052.46%20 - 70
Tabatabaei-Malazy et al (2016) [30]IranATP III6,0822,11834.82%> 25
Zoghi et al (2016) [31]IranATP III1,414745.23%35 - 70
Olafsdottir et al (2016) [32]IcelandJIS18210.54%18
Zhu et al (2017) [33]ChinaATP III1,29325319.56%> 18
Damiri et al (2018) [34]PalestineIDF346298.38%18 - 65
Placzkowska et al (2018) [35]PolandIDF26172.68%18 - 31