Obesity represents one of the most significant public health challenges worldwide. Current clinical practice relies on body mass index (BMI) to define the obesity status of an individual, even though the index has long been recognized for its limitations as a measure of body fat. In normal BMI individuals, increased central adiposity has been associated with worse health outcomes, including increased risks of cardiovascular disease and metabolic disorders. The condition leading to these outcomes has been described as metabolic obesity in the normal weight (MONW). More recent evidence suggests that MONW is associated with increased risk of several obesity-related malignancies, including postmenopausal breast, endometrial, colorectal, and liver cancers. In MONW patients, the false reassurance of a normal range BMI can lead to lost opportunities for implementing preventive interventions that may benefit a substantial number of people. A growing body of literature has documented the increased risk profile of MONW individuals and demonstrated practical uses for body composition and biochemical analyses to identify this at-risk population. In this review, we survey the current literature on MONW and cancer, summarize pathophysiology and oncogenic mechanisms, highlight potential strategies for diagnosis and treatment, and suggest directions for future research.

中文翻译：

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正常体重代谢性肥胖者的癌症风险：叙述性回顾

肥胖是全球最重大的公共卫生挑战之一。当前的临床实践依靠体重指数（BMI）来定义个体的肥胖状况，尽管该指数长期以来一直被认为作为身体脂肪衡量标准的局限性。在体重指数正常的个体中，中心性肥胖增加与健康状况恶化有关，包括心血管疾病和代谢紊乱的风险增加。导致这些结果的病症被描述为正常体重的代谢性肥胖（MONW）。最近的证据表明，MONW 与多种肥胖相关恶性肿瘤的风险增加有关，包括绝经后乳腺癌、子宫内膜癌、结直肠癌和肝癌。对于 MONW 患者，错误地保证 BMI 处于正常范围可能会导致失去实施预防性干预措施的机会，而这些预防性干预措施可能使大量人受益。越来越多的文献记录了 MONW 个体风险状况的增加，并证明了身体成分和生化分析在识别这一高危人群方面的实际用途。在这篇综述中，我们调查了有关 MONW 和癌症的现有文献，总结了病理生理学和致癌机制，强调了潜在的诊断和治疗策略，并提出了未来研究的方向。