A BMI in the normal range associates with a decreased risk of cardiometabolic disease and all-cause mortality. However, not all subjects in this BMI range have this low risk. Compared to people who are of normal weight and metabolically healthy, subjects who are of normal weight but metabolically unhealthy (∼20% of the normal weight adult population) have a greater than 3-fold higher risk of all-cause mortality and/or cardiovascular events. Here we address to what extent major risk phenotypes determine metabolic health in lean compared to overweight and obese people and provide support for the existence of a lipodystrophy-like phenotype in the general population. Furthermore, we highlight the molecular mechanisms that induce this phenotype. Finally, we propose strategies as to how this knowledge could be implemented in the prevention and treatment of cardiometabolic diseases in different stages of adiposity in routine clinical practice.

中文翻译：

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人体代谢不正常体重的原因，特征和后果。

体重指数在正常范围内会降低心脏代谢疾病和全因死亡率的风险。但是，并非此BMI范​​围内的所有受试者都具有这种低风险。与体重正常且代谢健康的人相比，体重正常但代谢不健康的人（约占正常体重成年人的20％）的全因死亡率和/或心血管疾病的风险高出三倍以上事件。在这里，我们讨论与超重和肥胖人群相比，主要风险表型在多大程度上决定了瘦肉的代谢健康，并为一般人群中脂代谢障碍样表型的存在提供了支持。此外，我们重点介绍了诱导该表型的分子机制。最后，