Phenotypic Variability of Body Composition in Men Adjusted for Body Mass Index and Body Fat Percentage
Keywords:
obesity, body composition, BMI, body fat, visceral fat, anthropometric indices, phenotypeAbstract
Obesity represents major health and social problem, and in clinical practice, its assessment is based primarily on body mass index (BMI). This index is practical and widely used, but it has certain limitations which, especially in men, can lead to incorrect classification. The aim of the study was to evaluate the body composition of a group of 201 men in terms of several anthropometric indices adjusted for body mass index and body fat percentage (PBF), and five phenotypes were defined. BMI was unable to distinguish between phenotypes with different body composition within the same weight category, such as the phenotypes normal weight obesity (NWO) and normal weight without obesity (NWWO). Both groups were defined as normal weight by BMI, but NWO had higher PBF, VFL, and WC compared to NWWO (P < 0.05). The phenotypes overweight obesity (OWO) and overweight without obesity (OWWO) were also evaluated similarly. OWO had significantly higher fat mass than OWWO (P < 0.05). An interesting contrast was observed between the NWO and OWO phenotypes, as their fat mass indices did not differ significantly. In contrast, significant differences were found in the fat-free mass indices (P < 0.05). These findings suggest that based on BMI alone, the NWO phenotype would be considered non-risk without further specification, although its fat mass is comparable to the morbid obesity of the OWO phenotype. Increased fat mass is associated with cardiometabolic risk, which is exacerbated when accompanied by low muscle mass, representing a particularly adverse phenotype with higher morbidity and mortality. Therefore, the assessment of obesity should also be based on body composition indices and not solely on BMI.
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