Clinical Report: Systematic Review of the Metabolically Obese Normal Weight Phenotype
Overview
This systematic review synthesizes evidence on the metabolically obese normal weight (MONW) phenotype in children and adolescents, highlighting its prevalence and early-life determinants.
Background
The MONW phenotype poses a significant public health challenge as children with normal BMI can still exhibit adverse metabolic profiles, increasing their risk for long-term cardiometabolic complications.
Data Highlights
Prevalence of MONW
Range
Reported Prevalence
10.6% to 56.2%
Key Findings
MONW prevalence varies significantly based on diagnostic criteria and population studied.
Children with MONW exhibit higher visceral adiposity, insulin resistance, dyslipidaemia, hypertension, and impaired glucose metabolism.
Early-life determinants of MONW include extremes of birth weight, rapid infant weight gain, and unhealthy dietary patterns.
The overall risk of bias across studies was low to moderate, primarily due to residual confounding and heterogeneous definitions of MONW.
There is a need for harmonized definitions of MONW.
Clinical Implications
Healthcare professionals should consider metabolic health assessments beyond BMI to identify children at risk for MONW. Early risk stratification incorporating metabolic markers and body composition measures may facilitate timely interventions.
