The concept of metabolically unhealthy vs. healthy obese (MUO vs. MHO) was expanded to non-obese individuals as obesity-related comorbidities exist in a subgroup of metabolically unhealthy vs. healthy normal-weight (MUNW vs. MHNW) . It is unclear if MUNW differs from MHO with respect to cardiometabolic health. Here, we applied a widely accepted definition of metabolic health (JAMA 20285: 2486) and examined differences in cardiometabolic risk factors among 4 subgroups of Korean adults (N=7,594) . Individuals with NW vs. obesity (BMI ≥25 kg/m2) were categorized as either MU or MH if those met one or more of the following criteria: triglyceride ≥150 mg/dl; fasting glucose ≥100 mg/dl; HDL <40 mg/dl in men or <50 mg/dl in women; and SBP ≥130 mmHg or DBP ≥85 mmHg. Despite a gradual increase in BMI and visceral adiposity index from MHNW to MUNW to MHO to MUO, surrogates of insulin resistance (TG/HDL) and arterial stiffness (estimated pulse wave velocity) were higher in MUNW vs. MHO (Table) . HOMA-IR was highest in MUO with no difference between MUNW and MHO (Table) . Individuals with MUNW vs. MHO are at least similar to or more vulnerable to cardiometabolic disease. Our data indicate that cardiometabolic risk is not solely dependent on adiposity, suggesting that early preventive efforts for chronic disease are needed for individuals with normal-weight, yet metabolically unhealthy.
M.Seo: None. W.Cho: None. J.Rosenberg: None. L.White: None. J.Kim: n/a.